Sulphonylurea-associated hypoglycemia - Introduction:
Sulfonylureas cause hypoglycemia by stimulating ß-cells to secrete insulin in the presence of glucose. Thus, intravenous dextrose can prolong the hypoglycaemia.
Suspect this diagnosis if hypoglycemia is prolonged or not responding to dextrose treatment.
Sulfonylurea-induced hypoglycemia is more likely in patients with:
Treatment is Octreotide, 50 mg given subcutaneously or intravenously STAT
Glucagon is not effective as the hepatic glycogen stores are usually exhausted by prolonged hypoglycemia