The effectiveness of various doses of octreotide for sulfonylurea-induced hypoglycemia after overdose

Abstract

This study was conducted to investigate the effectiveness of various doses of octreotide in reducing hypoglycemic attacks and the need for dextrose in patients with refractory and recurrent hypoglycemia related to sulfonylurea toxicity. This study was carried out at the Center of Experimental Research of Selcuk University Meram School of Medicine in Konya, Turkey. A total of 40 New Zealand rabbits of both sexes, weighing between 2500 and 3000 g, were used in this experiment. Rabbits were randomly divided into 4 groups, each of which consisted of 10 animals. All animals were given oral gliclazide 100 mg. For the treatment of hypoglycemic attacks in group I, only 15 mL of 50% dextrose (7.5 g) was given intravenously; in groups II, III, and IV, octreotide was given in doses of 25 ug, 50 ug, and 100 ug, respectively. Octreotide was given to groups II, III, and IV at the 8th hour (when hypoglycemic attacks were induced), along with an intravenous infusion of an additional 15 mL of 50% dextrose (7.5 g) for each hypoglycemic attack that occurred. After the toxic dose was given, the rabbits were given the amount of dextrose used before and after octreotide administration, and the numbers of hypoglycemic attacks were recorded. The values of blood glucose for all animals were read every hour on the hour from the beginning of the study, and the study ended at the 24th hour, when hypoglycemic attacks stopped. A significant difference was observed between groups I, II, and IV in numbers of hypoglycemic attacks that occurred and dextrose doses given between 9 and 24 h (P=.001). The findings of this study suggest that a single dose of octreotide 100 ug may be used to reduce the number of refractory and recurrent hypoglycemic attacks that occur because of sulfonylurea overdose; large prospective studies are needed to validate these findings.