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Hypoglycemia Secondary to Sulfonylurea Ingestion in a Patient with End Stage Renal Disease: Results from a 72-Hour Fast
Joint Authors
Abraham, Alice
Rubin, Mishaela
Accili, Domenico
Pajvani, Utpal B.
Bilezikian, John P.
Source
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-11-17
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Insulin, proinsulin, and C-peptide levels increase with sulfonylurea exposure but the acuity of increase has not been described in dialysis patients.
We present a case of a dialysis patient who presented with hypoglycemia and was found to have accidental sulfonylurea ingestion.
This is a 73-year-old man with ESRD on peritoneal dialysis, without history of diabetes, who presented with hypoglycemia.
Past medical history includes multiple myeloma, congestive heart failure, and hypertension.
At initial presentation, his blood glucose was 47 mg/dL, with concomitant elevations in the following: C-peptide 30.5 (nl: 0.8–3.5 ng/mL), insulin 76 (nl: 3–19 μIU/mL), and proinsulin 83.3 (nl: ≤8.0 pmol/L).
During the 72-hour fast, which he completed without hypoglycemia, insulin declined to be within normal limits (to 12 μIU/mL); proinsulin (to 12.1 pmol/L) and C-peptide (to 7.2 ng/mL) levels decreased but remained elevated.
The sulfonylurea screen ultimately returned positive for glipizide, clinching the diagnosis.
This is the first reported case which characterizes the chronic elevation of proinsulin in a patient with ESRD, as well as its dramatic increase after a presumed solitary exposure to sulfonylurea.
The 72-hour fast conducted gives insight into the clearance of insulin, proinsulin, and C-peptide after sulfonylurea ingestion in ESRD.
American Psychological Association (APA)
Abraham, Alice& Rubin, Mishaela& Accili, Domenico& Bilezikian, John P.& Pajvani, Utpal B.. 2015. Hypoglycemia Secondary to Sulfonylurea Ingestion in a Patient with End Stage Renal Disease: Results from a 72-Hour Fast. Case Reports in Endocrinology،Vol. 2015, no. 2015, pp.1-4.
https://search.emarefa.net/detail/BIM-1058419
Modern Language Association (MLA)
Abraham, Alice…[et al.]. Hypoglycemia Secondary to Sulfonylurea Ingestion in a Patient with End Stage Renal Disease: Results from a 72-Hour Fast. Case Reports in Endocrinology No. 2015 (2015), pp.1-4.
https://search.emarefa.net/detail/BIM-1058419
American Medical Association (AMA)
Abraham, Alice& Rubin, Mishaela& Accili, Domenico& Bilezikian, John P.& Pajvani, Utpal B.. Hypoglycemia Secondary to Sulfonylurea Ingestion in a Patient with End Stage Renal Disease: Results from a 72-Hour Fast. Case Reports in Endocrinology. 2015. Vol. 2015, no. 2015, pp.1-4.
https://search.emarefa.net/detail/BIM-1058419
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1058419