Prolonged Hypoglycemia | Use of Sulfonylurea and Its Treatment with Octreotide

 

Patients at risk for prolonged hypoglycemia:

(1) overdosage

(2) drug-induced interaction (for example, with ciprofloxacin)

(3) frail elderly

(4) chronic renal failure (associated with retention of an active metabolite)

 

Problems with usual management of hypoglycemia:

(1) The fluid volume required can be a problem for certain patients.

(2) The administration of glucose in high doses results in further release of insulin, causing a rebound hypoglycemia.

(3) Glucagon has little if any benefit in treating it.

 

Octreotide is a synthetic somatostatin analogue that inhibits release of insulin from the beta cells of the pancreas.

 

One regimen is 50 micrograms administered subcutaneously given every 8 hours as needed for a total of 3 doses (total time 24 hours). The drug may also be given intravenously.