Abstract
We determined the clinical features of severe sulfonylurea-induced hypoglycemia by analyzing 35 subjects with diabetes in the last 3 years. They averaged 76.7±1.4 years of age, with 25 (71.4%) over 75 years old. They averaged 6.7±0.4 drugs administered daily. By drug, 19 were administered glimepiride, 15 glibenclamide, and 1 gliclazide. Among the glimepiride-treated, 15 (78.9%) were administered over 3 mg. Of the glibenclamide-treated, 10 (66.7%) were administered over 5 mg. Overall HbA1c averaged 6.5±0.1%, with 12 of the 35 (34.3%) having HbA1c below 6.0%. Of the 12, 11 (91.7%) were older than 75 years and 9 (75.0%) were administered over 3 mg of glimepiride, 5 mg of glibenclamide, or 120 mg of gliclazide-excessive for their HbA1c and age-indicating that sulfonylurea administration in the elderly with diabetes should be reevaluated for appropriate dosing if unwanted effects such as hypoglycemia are to be avoided.
