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[Successful treatment of severe sulfonylurea-induced hypoglycemia by the subcutaneous administration of octreotide in an elderly patient with diabetes: A case report].
- Source :
-
Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics [Nihon Ronen Igakkai Zasshi] 2019; Vol. 56 (3), pp. 336-342. - Publication Year :
- 2019
-
Abstract
- Sulfonylureas, a potent stimulator of insulin release from pancreatic β cells, can cause hypoglycemia, which is apt to recur with a prolonged duration in elderly patients. Octreotide acetate, a long-acting somatostatin analogue, suppresses the secretion of insulin and is recognized as a possible treatment for sulfonylurea-induced hypoglycemia. However, there are few reports on its use in an actual clinical setting, especially in the elderly. We herein report a case in which subcutaneous injection of octreotide was effective for treating prolonged and recurrent hypoglycemia caused by sulfonylureas in an elderly man. An 89-year-old man was transported to the emergency department of our hospital for disturbance of consciousness in the morning. He had been treated for type 2 diabetes with 0.5 mg glimepiride, with the most recent HbA1c measurement being 5.7%. His plasma glucose level was low (22 mg/dL), and he was in a coma (Japan Coma Scale: 300). Under a diagnosis of hypoglycemic coma caused by sulfonylurea, we dripped 10% glucose solution and administered 50% glucose solution every 1 to 2 h through a peripheral vein, but his hypoglycemia recurred several times. Finally, 50 μg octreotide was subcutaneously injected. Thereafter, hypoglycemia did not recur, and additional injections of 50% glucose solution were not required. The same dose of octreotide was additionally administered after 8 h. In conclusion, the subcutaneous injection of octreotide can be an effective and safe method of treating prolonged hypoglycemia caused by sulfonylureas in the elderly.
- Subjects :
- Administration, Cutaneous
Aged, 80 and over
Blood Glucose analysis
Humans
Hypoglycemia chemically induced
Male
Octreotide administration & dosage
Sulfonylurea Compounds therapeutic use
Treatment Outcome
Diabetes Mellitus, Type 2 drug therapy
Hypoglycemia drug therapy
Octreotide therapeutic use
Sulfonylurea Compounds adverse effects
Subjects
Details
- Language :
- Japanese
- ISSN :
- 0300-9173
- Volume :
- 56
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
- Publication Type :
- Academic Journal
- Accession number :
- 31366755
- Full Text :
- https://doi.org/10.3143/geriatrics.56.336