Drug-induced hypoglycemia is low blood levels of a sugar called glucose caused by a medication.
Causes, incidence, and risk factors
The most common cause of medication-induced hypoglycemia is improper management of diabetes. Missing meals, overexertion, and intentional or unintentional overdose of medications used to treat the condition can all cause blood glucose levels to drop. Medications that can cause hypoglycemia include insulin and sulfonylureas. Newer drugs for diabetes such as metformin (Glucophage) can also cause hypoglycemia when used in combination with sulfonylureas. The condition may also occur when a nondiabetic individual takes insulin or a sulfonylurea drug. Other drugs such as pentamidine can also occasionally induce hypoglycemia. Rarer causes of low blood glucose include the use of quinidine, quinine, beta-blocker drugs, MAO inhibitors (a type of antidepressant), Bactrim (an antibiotic), and haloperidol.
Signs and tests
Signs of hypoglycemia may include:
tremulousness tachycardia (fast heartbeat) diaphoresis (sweating) ataxia (movement problems) convulsions confusion lethargy coma Tests may show:
low plasma glucose in cases where people without diabetes have taken drugs for the condition:
elevated serum insulin with low serum C-peptide urine positive for sulfonylureas
Treatment
Treatment consists of administration of glucose. In addition, a diabetic's treatment regimen should be reviewed to avoid further problems.
Expectations (prognosis)
Short-term prognosis is favorable if hypoglycemia is detected and treated. However, chronic and repeated episodes of hypoglycemia may damage the brain and nerves.
Complications
Complications of severe or prolonged hypoglycemia include neurologic damage, convulsions, and coma.
Calling your health care provider
Call your health care provider if you have symptoms of hypoglycemia and be sure to mention any medications you believe may be associated with the condition.
Prevention
Prevention for diabetics includes monitoring of blood glucose at home and appropriate attention to diet and routine, particularly if symptoms occur. In addition, it is important to discuss any planned changes of diet, exercise, travel, weight, or routine with your health care provider. The treatment regimen can then be adjusted in advance to prevent hypoglycemia.