Octreotide Treatment for Hypoglycemic Refractory Case Caused by Sulfonylureas with Impaired Renal Function

Authors

  • Taufiq Abdullah Department of Emergency Medicine Faculty of Medicine Universitas Brawijaya Malang
  • Ali Haedar Department of Emergency Medicine Faculty of Medicine Universitas Brawijaya Malang
  • Budi Soenarto Department of Emergency Medicine Faculty of Medicine Universitas Brawijaya Malang

DOI:

https://doi.org/10.21776/ub.jkb.2023.032.04.11

Keywords:

Glibenclamide, octreotide, overdose, refractory hypoglycemia, sulfonylureas

Abstract

Hypoglycemia is an emergency case that is caused by antidiabetic drugs from the sulfonylurea class. Prolonged and refractory hypoglycemia can increase mortality and morbidity. Renal impairment can result in recurrent hypoglycemic symptoms and require special treatment. In this study case, a 47-year-old woman with newly impaired renal function presented in a coma caused by hypoglycemia due to the use of glibenclamide (sulfonylurea drugs) that did not respond to standard hypoglycemic treatment. Treatment of refractory hypoglycemia is a challenge in itself. Octreotide may be considered in cases of refractory hypoglycemia that does not respond to standard glucose treatment, where in this case refractory hypoglycemia is caused by accumulating sulfonylurea because of impaired renal function.

Downloads

Download data is not yet available.

References

Kumar JG, Abhilash KPP, Saya RP, Tadipaneni N, and Bose JM. A Retrospective Study on the Epidemiology of Hypoglycemia in the Emergency Department. Indian Journal of Endocrinology and Metabolism. 2017; 21(1): 119–124.

Wang J, Geiss LS, Williams DE, and Gregg EW. Trends in Emergency Department Visit Rates for Hypoglycemia and Hyperglycemic Crisis among Adults with Diabetes, United States, 2006-2011. PLoS One. 2015; 10(8): 1-10.

Aghaali M and Saghafi H. Comparing the Incidence of Hypoglycemia Episodes in Patients with Type 2 Diabetes and Chronic Kidney Disease Treated with Insulin or Glibenclamide. Clinical Diabetology. 2018; 7(3): 159–163.

Schloot NC, Haupt A, Schütt M, et al. Risk of Severe Hypoglycemia in Sulfonylurea-Treated Patients from Diabetes Centers in Germany/Austria: How Big is the Problem? Which Patients are at Risk? Diabetes Metabolism Research and Reviews. 2016; 32(3): 316–324.

Zaid AH, Sapru S, Costello J, Boradia C. Sulfonylurea Induced Severe Hypoglycemia in a Diabetic with Renal Failure— A Case Report. Journal of Biosciences and Medicines. 2015; 03(11): 68–70.

Alsahli M and Gerich JE. Hypoglycemia in Patients with Diabetes and Renal Disease. Journal of Clinical Medicine. 2015; 4(5): 948–964.

Yamaguchi S, Ikejima M, Furukawa A, Abe M, Nakazaki M, and Ishihara H. Octreotide for Hypoglycemia Caused by Sulfonylurea and DPP-4 Inhibitor. Diabetes Research and Clinical Practice. 2015 Aug 1; 109(2): 8–10.

Klein-Schwartz W, Stassinos GL, and Isbister GK. Treatment of Sulfonylurea and Insulin Overdose. British Journal of Clinical Pharmacology. 2016; 81(3): 496–504.

Costello RA, Nicolas S, and Shivkumar A. Sulfonylureas. (Online) 2022. https://www.ncbi.nlm.nih.gov/books/NBK513225/ [accessed 2022 September 6].

Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney International. 2021; 99(3): 1–87.

Dougherty PP and Klein-Schwartz W. Octreotide's Role in the Management of Sulfonylurea-Induced Hypoglycemia. Journal of Medical Toxicology. 2010; 6(2): 199–206.

Watson MR, Ward CT, Prabhakar A, Fiza B, and Moll V. Successful Use of Octreotide Therapy for Refractory Levofloxacin-Induced Hypoglycemia: A Case Report and Literature Review. Case Report in Critical Care. 2019; 2019: 1-5.

Downloads

Published

2023-08-31

Issue

Vol. 32 No. 4 (2023)

Section

Case Report

License

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).