2007 Volume 50 Issue 2 Pages 129-135
The incidence of drug-induced severe hypoglycemia could be higher than is currently estimated. We reviewed our three-year experience with drug-induced hypoglycemia in 50 patients of type 2 diabetes mellitus (29 men, 21 women, median age 75.6 years, range 49-97) who presented with disturdance of consciousness. Of the 50, 36 patients were being treated with a sulfonylurea, 13 with insulin, and 1 with both a sulfonylurea and insulin. The HbA1c was 6.0% or less 23 patients. The severe hypoglycemia in our patients could be explained mainly by an inadequate prescription of sulfonylurea to high-risk patients or patients with renal dysfunction, liver dysfunction or reduced energy intake. High-risk patients for drug-induced hypoglycemia are elderly patients and patients with renal dysfunction. Of the Total, 24 patients were found in a coma, and the median duration of coma estimated from their histories was 7.3 hours (range 1-24). Three patients estimated to have been is a state of hypoglycemia for more than 10 hours did not recover from the coma. The older the patients of diabetes mellitus become, the more frequently doctors other than specialists are involved in the treatment of diabetes mellitus. Adequate guidelines are desired, especially for the treatment of diabetes mellitus in elderly patients or those with renal dysfunction.
