Abstract
Although many cases of hypoglycemia due to the administration of oral hypoglycemic agents have been reported, no case of hypoglycemia produced by gliclazide has yet been reported in Japan. In this paper, we describe such a case.
A 60-year-old woman with a 13-year history of diabetes mellitus was admitted to our hospital because of unconsciousness. She had been taking gliclazide (Diamicron) for 2 years and 10 months prior to admission.
Although she had not eaten lunch, she took gliclazide at 2 p.m. on Sept. 24, 1978. Subsequently, she was admitted to hospital in a comatose state. On admission, her blood sugar was below 45 mg/dl. She regained consciousness after glucose infusion, but then suffered further attacks of hypoglycemia and was administered 281.5 g of glucose over a period of about 35 hours. At approximately 18 hours after she had taken the last gliclazide, the patient's serum gliclazide concentration was 1.2μg/ml, and she had not yet recovered from the hypoglycemic state at that time. Although it is said that the half life of gliclazide is about 8-10 hours and that the lowest level of gliclazide to produce hypoglycemia is 2-6μg/ml, it can be surmised that the serum gliclazide concentratioh must be higher than 2 μg/ml/ at the time of a hypoglycemic attack.
It is suggested that the patient's low renal function and lack of having eaten were contributory factors in her prolonged hypoglycemia produced by gliclazide.
