Clinical characteristics of drug-induced hypoglycemia in non-diabetic patients

Abstract

Objective To explore the clinical characteristics of drug-induced hypoglycemia in non-diabetic patients. Methods A case of hypoglycemia caused by sexual enhancement medication containing oral antidiabetic agents was presented. Data of drug-induced hypoglycemia in non-diabetic patients admitted in Peking Union Medical College Hospital from January 2008 to December 2017 were collected and analyzed. Results Glibenclamide, phenformin and sildenafil were confirmed by high performance liquid chromatography and liquid chromatography-quadrupole-time of flight mass spectrometry in the sexual enhancement medication, and no recurrent hypoglycemia occurred after discontinuation of the agent. In the past 10 years, a total of 12 cases were admitted in Peking Union Medical College Hospital with the diagnose of drug-induced hypoglycemia in non-diabetic patients. The onset age was 13-76 years old with the median of 64 years old, and the ratio of male to female was 11∶1. The drug components test was performed in 8 cases and demonstrated that glyburide was the most common agent (100%), followed by gliquidone, metformin and phenformin. The common features of drug-induced hypoglycemia in non-diabetic patients were as the follows: no history of sever hepatic and renal diseases, irregular seizures onset pattern, plasma glucose level often less than 2.0 mmol/L at episodes, no significant imaging abnormalities, suspected medication history. Conclusion Drug-induced hypoglycemia should be considered in the clinical setting of hypoglycemia in non-diabetic patients. Detailed medication history and drug components test are crucial for the diagnosis and management. Key words: Hypoglycemia; Drug; Glibenclamide; Phenformin; Sildenafil