NDLI: Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide

Content Provider	Springer Nature : BioMed Central
Author	Lheureux, Philippe ER Zahir, Soheil Penaloza, Andrea Gris, Mireille
Abstract	The major potential adverse effect of use of sulfonylurea agents (SUAs) is a hyperinsulinaemic state that causes hypoglycaemia. It may be observed during chronic therapeutic dosing, even with very low doses of a SUA, and especially in older patients. It may also result from accidental or intentional poisoning in both diabetic and nondiabetic patients. The traditional approach to SUA-induced hypoglycaemia includes administration of glucose, and glucagon or diazoxide in those who remain hypoglycaemic despite repeated or continuous glucose supplementation. However, these antidotal approaches are associated with several shortcomings, including further exacerbation of insulin release by glucose and glucagon, leading only to a temporary beneficial effect and later relapse into hypoglycaemia, as well as the adverse effects of both glucagon and diazoxide. Octreotide inhibits the secretion of several neuropeptides, including insulin, and has successfully been used to control life-threatening hypoglycaemia caused by insulinoma or persistent hyperinsulinaemic hypoglycaemia of infancy. Therefore, this agent should in theory also be useful to decrease glucose requirements and the number of hypoglycaemic episodes in patients with SUA-induced hypoglycaemia. This has apparently been confirmed by experimental data, one retrospective study based on chart review, and several anecdotal case reports. There is thus a need for further prospective studies, which should be adequately powered, randomized and controlled, to confirm the probable beneficial effect of octreotide in this setting.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc3807.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc3807
Journal	Critical Care
Issue Number	6
Volume Number	9
Language	English
Publisher	BioMed Central
Publisher Date	2005-09-07
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Glucagon Octreotide Diazoxide Gliclazide Glucose Infusion
Content Type	Text
Resource Type	Review
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide

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