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

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...

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Main Authors:	Lheureux, Philippe ER, Zahir, Soheil, Penaloza, Andrea, Gris, Mireille
Format:	Online
Language:	English
Published:	BioMed Central 2005
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414034/

id	pubmed-1414034
recordtype	oai_dc
spelling	pubmed-14140342006-03-28 Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide Lheureux, Philippe ER Zahir, Soheil Penaloza, Andrea Gris, Mireille Review 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. BioMed Central 2005 2005-09-07 /pmc/articles/PMC1414034/ /pubmed/16356235 http://dx.doi.org/10.1186/cc3807 Text en Copyright © 2005 BioMed Central Ltd
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Lheureux, Philippe ER Zahir, Soheil Penaloza, Andrea Gris, Mireille
spellingShingle	Lheureux, Philippe ER Zahir, Soheil Penaloza, Andrea Gris, Mireille Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide
author_facet	Lheureux, Philippe ER Zahir, Soheil Penaloza, Andrea Gris, Mireille
author_sort	Lheureux, Philippe ER
title	Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide
title_short	Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide
title_full	Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide
title_fullStr	Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide
title_full_unstemmed	Bench-to-bedside review: Antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide
title_sort	bench-to-bedside review: antidotal treatment of sulfonylurea-induced hypoglycaemia with octreotide
description	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.
publisher	BioMed Central
publishDate	2005
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414034/
_version_	1611381483124031488

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

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