Abstract
An 85-year-old man hospitalized for heart failure demonstrated frequent extra ventricular systoles. Disopyramide (DPM)(100mg, three times daily) was prescribed for the latter symptom.On the 11th hospital day, he became unresponsive with a fasting serum glucose level of 21mg/dl.His mental status improved after intravenous dextrose infusion.Hypoglycemia did not reocur after discontinuing the DPM therapy.During the hypoglycemic attack, his fasting plasma insulin level and insulin-glucose ratio were normal.Euglycemic hyperinsulinemic clamp showed no increase in tissue sensitivity to insulin.His plasma glucose response to intravenous injection of 1mg of glucagon was less than 1/2 that of normal subjects, and no rise in plasma insulin was observed.These results suggest that the mechanism of DPM-induced hypoglycemia may be related to impairment of glycogen storage.
