Drug-Induced Hypoglycaemia

  title={Drug-Induced Hypoglycaemia},
  author={Chaker Ben Salem and Neila Fathallah and Houssem Hmouda and Kamel Bouraoui},
  journal={Drug Safety},
Drugs are the most frequent cause of hypoglycaemia in adults. Although hypoglycaemia is a well known adverse effect of antidiabetic agents, it may occasionally develop in the course of treatment with drugs used in everyday clinical practice, including NSAIDs, analgesics, antibacterials, antimalarials, antiarrhythmics, antidepressants and other miscellaneous agents. They induce hypoglycaemia by stimulating insulin release, reducing insulin clearance or interfering with glucose metabolism… 
Drugs and Hypoglycemia
There are various groups of drugs with provable hypoglycemic effects that may potentiate diabetes mellitus treatment or lead to hypoglycemia in nondiabetic patients as well (Table 1).
An unconscious man with profound drug-induced hypoglycaemia
This work is the first to document a significant rise in endogenous insulin production in a hypoglycaemic patient presenting with tramadol intoxication, and suggests that hyperinsulinemia could be the cause of the Hypoglycaemia associated with tramADol use.
Sulfasalazine-Induced Hypoglycemia in a Patient with Type 2 Diabetes and End-Stage Renal Disease
Clinicians should be aware of the potential hypoglycemic effect of sulfasalazine and doses should be reduced in patients diagnosed with persistent hypoglycemia.
Persistent Hypoglycemia of Unknown Etiology in a Patient Without Diabetes
In this case report, a 51-year-old female with multiple medical conditions including bipolar disorder and no history of diabetes was admitted for evaluation and treatment of hypoglycemia and a battery of tests were ordered to evaluate intrinsic and extrinsic causes.
Hydroquinine hydrobromide and hypoglycaemia Introduction
  • Medicine
  • 2014
In a randomized, double-blind, placebocontrolled trial, conducted in the Netherlands, 300 mg hydroquinine hydrobromide was considered safe if used for a short period and significantly more effective than placebo in the prevention of frequent, ordinary muscle cramps.
Hypoglycemia in Non-Diabetic In-Patients: Clinical or Criminal?
Significant non-diabetic hypoglycemia in hospital in–patients (at or below 2.7 mmol/l) outside critical care is rare, sufficiently rare for occurrences to merit case-note review and diagnostic blood tests, unless an obvious explanation is found.
Severe recurrent nocturnal hypoglycemia during chemotherapy with 6-mercaptopurine in a child with acute lymphoblastic leukemia
The first report of this type of hypoglycemia occurring in an Asian child including Korean is reported, likely due to 6-MP during chemotherapy, in an 8-year-old boy with acute lymphoblastic leukemia.


Comparative Tolerability Profiles of Oral Antidiabetic Agents
The sulphonylureas and the biguanides are widely used as adjuncts to dietary measures in the treatment of non-insulin-dependent diabetes mellitus (NIDDM) and are generally well tolerated, although pharmacokinetic differences between these agents have important clinical implications.
Drug-Induced Disorders of Glucose Metabolism
The hypoglycaemic effects of a drug may be turned to a therapeutic advantage in patients with diabetes mellitus or those who are at risk of developing glucose intolerance, despite the large number of anecdotal reports of drug-induced disturbances of glucose metabolism.
Comparative Tolerability of Sulphonylureas in Diabetes Mellitus
As a group of drugs, they are very well tolerated, but differences in overall tolerability can be identified, and cardiovascular risk factors may be modified by gliclazide, which seems unique among the sulphonylureas in this respect.
Drug-induced hypoglycemia. A review of 1418 cases.
  • H. Seltzer
  • Medicine
    Endocrinology and metabolism clinics of North America
  • 1989
Drug-induced Hypoglycemia: A Review Based on 473 Cases
In elderly diabetics taking any sulfonylurea agent, warfarin should be used for anticoagulation instead of bishydroxycoumarin, indomethacin for arthritic pain instead of phenylbutazone, and another agent than sulfisoxazole for urinary tract infections.
Drug-induced hypoglycemic coma in 102 diabetic patients.
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.
Drug-Drug and Food-Drug Pharmacokinetic Interactions with New Insulinotropic Agents Repaglinide and Nateglinide
  • A. Scheen
  • Biology, Medicine
    Clinical pharmacokinetics
  • 2007
Clinically relevant drug-drug interactions are those that occur when glinides are administered together with other glucose-lowering agents or compounds widely coadministered to diabetic patients, with drugs known to induce or inhibit glinide plasma levels leading to hypoglycaemia, CYP isoenzymes concerned in their metabolism, or with drugs that have a narrow efficacy: toxicity ratio.
Can insulin-treated diabetics be given beta-adrenergic blocking drugs?
It is concluded that beta-blocking drugs are generally safe in insulin-treated diabetics and that hypoglycaemic unconsciousness resulting from their use is rare.
Are Hypoglycaemia and Other Adverse Effects Similar Among Sulphonylureas?
  • M. Salas, J. Caro
  • Medicine
    Adverse drug reactions and toxicological reviews
  • 2002
More work is needed to homogenise the definition of hypoglycaemia, to get consensus on the methods for detection and data collection, as well as to further patient and physician education.