 |
|
Drug-Induced Hypoglycemic Coma in 102 Diabetic Patients
Haim Ben-Ami, MD;
Pradeep Nagachandran, MD;
Ayelet Mendelson, MD;
Yeouda Edoute, MD, PhD
Arch Intern Med. 1999;159:281-284.
Background Hypoglycemic coma is a continuous threat for diabetic patients treated with insulin and/or oral hypoglycemic agents; it may be associated with substantial morbidity and mortality.
Methods We retrospectively reviewed our clinical experience with drug-induced hypoglycemic coma during a 7-year period.
Results The study consisted of 102 patients and included 61 females and 41 males. The median age was 72 years. Ninety-two patients suffered from type 2 diabetes mellitus; 10 patients had type 1 diabetes mellitus. The median lowest blood glucose level was 1.77 mmol/L (32 mg/dL). Drug-induced hypoglycemic coma occurred in 99 patients out of the hospital, while 3 patients developed it during hospitalization. Drug-induced hypoglycemic coma occurred in patients undergoing treatment with insulin, glyburide, and combined therapy with insulin and glyburide, insulin and metformin, or glyburide and metformin. Ninety-three patients had at least 1 of the following risk factors: age older than 60 years, renal dysfunction, decreased intake of energy, and infection. Fourteen patients concomitantly received drugs that potentiated hypoglycemia. Forty patients responded to treatment within the first 12 hours, while 62 patients had protracted hypoglycemia of 12 to 72 hours' duration. Morbidity included physical injuries in 7 patients, myocardial ischemia in 2 patients, and stroke in 1 patient. Death occurred in 5 patients.
Conclusions Hypoglycemic coma is a serious and not an uncommon problem among elderly patients with diabetes mellitus and treated with insulin and/or oral hypoglycemic drugs. Risk factors contribute substantially to the morbidity and mortality of patients with drug-induced hypoglycemic coma. Enhanced therapeutic monitoring may be warranted when hypoglycemic drugs are administered to an elderly patient with the above predisposing factors and potentiating drugs for hypoglycemia.
From the Department of Internal Medicine C, Rambam Medical Center, and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Hyperglycemia Management in Non-critically Ill Hospitalized Patients
Arnold and Keller
Journal of Pharmacy Practice 2009;22:467-477.
ABSTRACT
Enhanced Glucose Tolerance by SK4 Channel Inhibition in Pancreatic {beta}-Cells
Dufer et al.
Diabetes 2009;58:1835-1843.
ABSTRACT
| FULL TEXT
Comparison of Inpatient Insulin Regimens with Detemir plus Aspart Versus Neutral Protamine Hagedorn plus Regular in Medical Patients with Type 2 Diabetes
Umpierrez et al.
J. Clin. Endocrinol. Metab. 2009;94:564-569.
ABSTRACT
| FULL TEXT
Management of Inpatient Hyperglycemia in Noncritically Ill Patients
Lansang and Umpierrez
Diabetes Spectr. 2008;21:248-255.
ABSTRACT
| FULL TEXT
Treating Elderly People with Diabetes and Stages 3 and 4 Chronic Kidney Disease
Abaterusso et al.
CJASN 2008;3:1185-1194.
ABSTRACT
| FULL TEXT
Randomized Study of Basal-Bolus Insulin Therapy in the Inpatient Management of Patients With Type 2 Diabetes (RABBIT 2 Trial)
Umpierrez et al.
Diabetes Care 2007;30:2181-2186.
ABSTRACT
| FULL TEXT
Hypoglycemia in Type 2 Diabetes: Pathophysiology, frequency, and effects of different treatment modalities
Zammitt and Frier
Diabetes Care 2005;28:2948-2961.
FULL TEXT
Causes of hyperglycemia and hypoglycemia in adult inpatients
Smith et al.
Am J Health Syst Pharm 2005;62:714-719.
ABSTRACT
| FULL TEXT
Management of Diabetes and Hyperglycemia in Hospitals
Clement et al.
Diabetes Care 2004;27:553-591.
FULL TEXT
Treatment of Patients Over 64 Years of Age With Type 2 Diabetes: Experience from nateglinide pooled database retrospective analysis
Del Prato et al.
Diabetes Care 2003;26:2075-2080.
ABSTRACT
| FULL TEXT
Safety and Efficacy of Repaglinide in Type 2 Diabetic Patients With and Without Impaired Renal Function
Hasslacher
Diabetes Care 2003;26:886-891.
ABSTRACT
| FULL TEXT
Diabetes in Elderly Adults
Meneilly and Tessier
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2001;56:5M-13.
ABSTRACT
| FULL TEXT
Comparison of Capillary Electrophoresis with HPLC for Diagnosis of Factitious Hypoglycemia
Paroni et al.
Clin. Chem. 2000;46:1773-1780.
ABSTRACT
| FULL TEXT
|
