Effectiveness of octreotide in a case of refractory sulfonylurea-induced hypoglycemia

The use of sulfonylurea medications in the treatment of type 2 diabetes mellitus is common. Patients who present to the Emergency Department after ingestion of excessive amounts of suflonylurea medications often have hypoglycemia refractory to dextrose administration. Standard care includes the administration of dextrose, glucagon, and diazoxide. Recently, the use of octreotide has been described as an alternative treatment in these patients. We present a case of a 20-year-old woman who ingested 900 mg of glyburide causing refractory hypoglycemia resistant to treatment with intravenous dextrose, glucagon, and diazoxide. Octreotide administration rapidly reversed hypoglycemia allowing patient stabilization and eventual discharge without any significant adverse events.