A Case of Severe Hypoglycemia Caused by Sulfonylurea Self-Administration in a Non-Diabetic Elderly Subject

Abstract

An 82-year-old man was admitted to our hospital with a consciousness disturbance. His plasma glucose level was low (22 mg/dL), but the results of other examinations were normal. We determined that the patient was in a hypoglycemic coma and administered 7.5-10 % glucose solution continuously and 50 % glucose solution every hour through a peripheral vein, but the patient's hypoglycemia did not improve. The next day, we inserted a central vein catheter in the right internal jugular vein and administered a 30 % glucose solution. The hypoglycemia and consciousness state improved after 36 hours and the patient was discharged after eight days of hospitalization. A blood analysis revealed a high concentration of glibenclamide (211.8 ng/mL) immediately after admission. During that time, he was not being treated for diabetes; however, his wife had been on antidiabetic medications, including glibenclamide. We therefore presumed that he had accidentally taken his wife's glibenclamide. Clinicians should be aware of the possible accidental ingestion of sulfonylureas, prescribed to other family members, particularly among elderly individuals.