Predisposing factors in fatal glibenclamide induced hypoglycaemia

Kennedy, Tess; Keat, A; Chester, Michael R.; Oakley, N. W.; Eastwood, J. B.

doi:10.1002/pdi.1960050508

“…Of the 19 patients who were sulphonylurea-positive despite not having diabetes, 7 were older than 80 years, in agreement with the findings of other workers 12,13 . This is a group in which impaired cardiac, hepatic or renal function may increase sensitivity to these drugs 14,15 . In general, however, the patients were young, as noted elsewhere 16 , some with a history of working in healthcare or having relatives taking sulphonylureas for diabetes.…”

Section: J O U R N a L O F T H E R O Y A L S O C I E T Y O F M E D I mentioning

confidence: 99%

Screening for Sulphonylureas in the Investigation of Hypoglycaemia

Kwong

¹

,

Teale

²

2002

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SUMMARYThe most important cause of hypoglycaemia in the presence of high insulin and C-peptide concentrations is insulinoma. However, a similar picture arises from use of sulphonylureas, which is sometimes covert. All specimens received in two years by a supraregional assay service laboratory from adults with low glucose and inappropriately high insulin and C-peptide concentrations were tested for sulphonylureas by a radioimmunoassay that employed antibodies to glibenclamide. In sulphonylurea-positive cases a questionnaire was sent to the consultant responsible for the patient, to elicit further information.Samples from 93 adult patients met the criteria, and 34 (37%) of these gave a positive result on screening for sulphonylureas. The consultants provided further information on 31 of the 34, and in 20 the presence of a sulphonylurea was unexpected. In 10 the features were such as to raise the possibility of factitious drug ingestion.A simple screening technique applied to specimens from patients with hyperinsulinaemic hypoglycaemia indicated that, in a substantial proportion of cases, the patient was taking a sulphonylurea.

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“…This is a group in which impaired cardiac, hepatic or renal function may increase sensitivity to these drugs 14,15 . In general, however, the patients were young, as noted elsewhere 16 , some with a history of working in healthcare or having relatives taking sulphonylureas for diabetes.…”

Section: J O U R N a L O F T H E R O Y A L S O C I E T Y O F M E D I mentioning

confidence: 99%

Screening for sulphonylureas in the investigation of hypoglycaemia

Kwong

¹

,

Teale

²

2002

JRSM

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SUMMARYThe most important cause of hypoglycaemia in the presence of high insulin and C-peptide concentrations is insulinoma. However, a similar picture arises from use of sulphonylureas, which is sometimes covert. All specimens received in two years by a supraregional assay service laboratory from adults with low glucose and inappropriately high insulin and C-peptide concentrations were tested for sulphonylureas by a radioimmunoassay that employed antibodies to glibenclamide. In sulphonylurea-positive cases a questionnaire was sent to the consultant responsible for the patient, to elicit further information.Samples from 93 adult patients met the criteria, and 34 (37%) of these gave a positive result on screening for sulphonylureas. The consultants provided further information on 31 of the 34, and in 20 the presence of a sulphonylurea was unexpected. In 10 the features were such as to raise the possibility of factitious drug ingestion.A simple screening technique applied to specimens from patients with hyperinsulinaemic hypoglycaemia indicated that, in a substantial proportion of cases, the patient was taking a sulphonylurea.

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Misleading statement

Drake¹

1989

Pract Diab Int

0

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Predisposing factors in fatal glibenclamide induced hypoglycaemia

Cited by 10 publications

References 7 publications

Screening for Sulphonylureas in the Investigation of Hypoglycaemia

Screening for Sulphonylureas in the Investigation of Hypoglycaemia

Screening for sulphonylureas in the investigation of hypoglycaemia

Misleading statement

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