Abstract
In the past 7 years, the authors had experience with utilizing 15 diabetic patients who had hypoglycemic comas during oral therapy by hypoglycemic agents (sulfonylurea derivatives). Most of the patients (11 male, 4 female), ranged in age from 44 to 74 years and were slender. Almost half of them were classified as the “occult type” of diabetes (moderate or mild hyperglycemia according to GTT, with a high renal threshold for sugar). The severity of their diabetes was moderate or mild and no mortalities resulted from the hypoglycemia.
In about a half of these patients, the hypoglycemic coma happened two or three times in one or two days, and the blood glucose concentration in those episodes was less than 45 mg/d/in every case. Duration of the coma ranged from 30 minutes to 8 hours.
As a result of the laboratory examinations, 10 of the 15 patients were found to have some degree of liver disorder which had not been found before the episode, though sulfonyl ureas were continuously given. Recovery from these disorders took place a short time after the episode;.
From the clinical observations above, the authors suggested that playing an important role in the cause of the liver disorders be considered as hypoglycemic coma during treatment by sulfonyl ureas.
