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Cited by 201Diabetes Management and ResearchDiabetes Treatment and ManagementPatient Safety and Medication Errors

Drug-Induced Hypoglycemic Coma in 102 Diabetic Patients

Ben-Ami, Haim, Nagachandran, Pradeep, Mendelson, Ayelet, Edoute, Yeouda·1999·Archives of Internal Medicine
DOI 10.1001/archinte.159.3.281
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Abstract

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.

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Crossref · 10.1001/archinte.159.3.281

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  • In a 7-year review of 102 cases of hypoglycemic coma secondary to either insulin or glyburide, 92 patients had type 2 diabetes, 7 sustained physical injury, 5 died, 2 suffered myocardial ischemia, and 1 patient had a stroke as a consequence of severe hypoglycemia.

    “In a 7-year review of 102 cases of hypoglycemic coma secondary to either insulin or glyburide (glibenclamide), 92 patients had type 2 diabetes, 7 sustained physical injury, 5 died, 2 suffered myocardial ischemia, and 1 patient had a stroke as a consequence of severe hypoglycemia (59).”

    From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [59]

  • Risk factors for severe hypoglycemia in people with type 2 diabetes treated with sulfonylureas include age, a past history of vascular disease, renal failure, reduced ingestion of food, alcohol consumption, and interactions with other drugs.

    “Risk factors for severe hypoglycemia in people with type 2 diabetes treated with sulfonylureas include age, a past history of vascular disease, renal failure, reduced ingestion of food, alcohol consumption, and interactions with other drugs (59,73,95-102).”

    From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [59]

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Authors
Ben-Ami, H., Nagachandran, P., Mendelson, A., & Edoute, Y.
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
1999-02-08
Volume
159
Issue
3
Pages
281
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.159.3.281
OpenAlex
W2045187622
Cited by
201
References
40
Citations by year
2025: 5 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 4 · 2020: 8 · 2019: 11 · 2018: 4 · 2017: 8 · 2016: 4 · 2015: 14 · 2014: 6 · 2013: 9 · 2012: 11
FWCI
2.53
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
Keywords
drug-induced hypoglycemia, hypoglycemic coma, type 2 diabetes, type 1 diabetes, insulin, glibenclamide, metformin, elderly patients, risk factors, renal dysfunction, infection, blood glucose monitoring, morbidity and mortality
MeSH terms
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Blood Glucose, Coma, Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Retrospective Studies

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