PMID: 11911598Mar 26, 2002Paper

Severe hypoglycemia in an elderly patient treated with metformin

International Journal of Clinical Pharmacology and Therapeutics
S ZitzmannH Schmechel

Abstract

The following case of severe hypoglycemia was reported during a systematic evaluation of hospital admissions caused by adverse drug reactions (supported by BfArM). A 79-year-old diabetic woman was admitted to hospital in a stuporous and unresponsive state. The initial physical examination revealed no other abnormal findings. Serum blood glucose was found to be 2.0 mmol/l and HbA1c was 4.6%. The patient had been started on antidiabetic therapy with metformin 2 months earlier. Treatment with other drugs being taken at that time, an ACE inhibitor, an NSAID and nitrofurantoin, remained unchanged. DIAGNOSIS, TREATMENT AND FOLLOW-UP: Laboratory tests excluded lactic acidosis and renal insufficiency. Cerebral computed tomography findings were normal. The patient improved dramatically following administration of glucose. Other laboratory findings confirmed the diagnosis of hypoglycemia. Blood glucose concentrations ranged between 4.0 and 10.0 mmol/l in the subsequent days and the patient could be discharged in full health. Drug-induced hypoglycemia is possible even in diabetics not receiving insulin or oral antidiabetic agents increasing insulin secretion. The risk of drug-induced hypoglycemia should be particularly considered when dru...Continue Reading

Citations

Apr 8, 2010·Brain : a Journal of Neurology·Geoffrey BirdTania Singer
Apr 3, 2013·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·S A Al-AbriK R Olson
Jul 10, 2003·Xenobiotica; the Fate of Foreign Compounds in Biological Systems·C WebberL C Rovati
Mar 27, 2009·The Kaohsiung Journal of Medical Sciences·Por-Wen YangHong-Da Lin
Jan 22, 2013·La Presse médicale·Michèle DickoElena Paillaud
May 11, 2012·Medicina clínica·Jorge Manzarbeitia Arambarri, Leocadio Rodríguez Mañas
Nov 13, 2002·Pharmacoepidemiology and Drug Safety
Aug 22, 2018·Journal of Intensive Care Medicine·George Sam Wang, Christopher Hoyte
Mar 8, 2019·Diabetes, Obesity & Metabolism·Alison J DunkleyUNKNOWN Primary Care Diabetes Society
Aug 19, 2018·Journal of Medical Case Reports·Sarah AldobeabanAbdussalam Ali Alshehri
Mar 26, 2019·Journal of Alzheimer's Disease : JAD·Angela KuhlaBrigitte Vollmar
Nov 6, 2009·Deutsches Ärzteblatt International·Michael A NauckIrfan Vardarli

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