Octreotide: A New Treatment for Severe Sulphonylurea-Induced Hypoglycaemia

Krentz, Andrew J.; Boyle, P J; Justice, K M; Wright, Alexander D.; Schade, David S.

doi:10.1042/cs082003pa

Cited by 2 publications

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“…More recently, octreotide, the pharmacological analogue of somatostatin, has been shown to be effective in sulphonylurea overdose (Krentz et al 1992). …”

Section: Management Of the Patient With Hypoglycaemiamentioning

confidence: 98%

Features, Prevention and Management of Acute Overdose Due to Antidiabetic Drugs

Moore

Wood

1993

Drug Safety

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Hypoglycaemic medication forms a disparate group of therapeutic compounds including insulin, the sulphonylureas and biguanides. They are all designed to prevent hyperglycaemia and in general are well tolerated. Careful prescribing practice and patient education by the physician can do much to reduce the risk of adverse effects from diabetic therapy. However, the presentation of adverse effects, together with accidental and non-accidental overdose, is a frequent clinical problem. Furthermore, the possible impairment of hypoglycaemic awareness in patients prescribed human insulin has added complexity to diabetic management. The cardinal features of insulin overdose are hypoglycaemia and hypokalaemia. The sulphonylureas predominantly cause hypoglycaemia, while the biguanides may precipitate lactataemia and acidosis. Recognition of hypoglycaemia is therefore crucial in avoidance of toxicity. Intravenous dextrose is the mainstay of therapy following gut decontamination (for the oral agents). The efficacy of glucagon is dependent on hepatic glycogen stores and should therefore be used with caution. Diazoxide is not recommended. More recently, octreotide has been shown to be effective in sulphonylurea overdose. Patients should be admitted and monitored with serial blood sugar measurements for a minimum of 1 to 2 days as clinically warranted.

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“…More recently, octreotide, the pharmacological analogue of somatostatin, has been shown to be effective in sulphonylurea overdose (Krentz et al 1992). …”

Section: Management Of the Patient With Hypoglycaemiamentioning

confidence: 98%

Features, Prevention and Management of Acute Overdose Due to Antidiabetic Drugs

Moore

Wood

1993

Drug Safety

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“…Diazoxide has been infused along with glucose in this situation to some effect (Johnson et al 1977). In theory, somatostatin should be effective by its ability to prevent insulin release, and there has been a recent report of the successful use of the somatostatin analogue, octreotide, in severe, prolonged hypoglycaemia with sulphonylureas (Krentz et al 1992). …”

Section: Hypoglycaemiamentioning

confidence: 97%

Problems and Pitfalls of Sulphonylurea Therapy in Older Patients

Robertson

Home

1993

Drugs & Aging

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The prevalence of non-insulin-dependent diabetes mellitus (type II) increases with age, so that approximately half of all known patients in English-speaking countries are over 65 years of age. There is no reason to believe that the criteria for blood glucose control should be any less stringent for elderly patients unless they have a limited life expectancy. Sulphonylurea drugs remain an effective means of achieving blood glucose control after failure of dietary therapy alone in older patients. However, changes in normal metabolism of drugs with age and the development of other pathologies in elderly patients make it important that these drugs are prescribed with care. Severe symptomatic hypoglycaemia is the most serious adverse effect of sulphonylurea drugs and this becomes progressively more likely with increasing age, depending primarily on the substantial reduction of renal function with normal aging. Other adverse effects are much less commonly of clinical importance. To minimise the risk of hypoglycaemia, it is important that patients receive closely supervised dietary management with education about their disease for at least 3 months before sulphonylurea drugs are prescribed. In elderly patients a short-acting agent with no active metabolites should be used. As patients become older, those receiving long-acting agents can be changed to short-acting agents before problems arise. If blood glucose control appears satisfactory on treatment, then symptoms of hypoglycaemia should be sought. If control is poor, then the criteria for introduction of insulin, with appropriate education, do not differ from those in younger patients.

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Octreotide: A New Treatment for Severe Sulphonylurea-Induced Hypoglycaemia

Cited by 2 publications

References 0 publications

Features, Prevention and Management of Acute Overdose Due to Antidiabetic Drugs

Features, Prevention and Management of Acute Overdose Due to Antidiabetic Drugs

Problems and Pitfalls of Sulphonylurea Therapy in Older Patients

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