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Hypoglycemia

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...

Hypoglycemia and Glucagon

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...

Oral Hypoglycemic Agents: Glinides

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...

Hyperglycemia

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...

Type I Diabetes III: Clinical Manifestations

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...

Diabetic Ketoacidosis l: Introduction

Diabetic Ketoacidosis l: Introduction

DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...

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Related Experiment Video

Updated: Jun 8, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Drug-induced hypoglycaemia: an update.

Chaker Ben Salem¹, Neila Fathallah, Houssem Hmouda

¹Department of Clinical Pharmacology, Faculty of Medicine of Sousse, and Medical Intensive Care Unit, Sahloul University Hospital, Sousse, Tunisia. bensalem.c@gmail.com

|October 15, 2010

Summary

Drug-induced hypoglycemia is common in adults, often caused by everyday medications beyond antidiabetic drugs. Awareness of these adverse effects is key for effective clinical management and prevention.

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Area of Science:

Pharmacology
Endocrinology
Clinical Medicine

Background:

Hypoglycemia is a significant adverse effect, most commonly linked to antidiabetic agents.
However, numerous non-antidiabetic drugs, including NSAIDs, analgesics, and antidepressants, can also induce hypoglycemia.
Certain drug-induced toxicities (hepatotoxicity, nephrotoxicity) and pancreatitis can indirectly lead to hypoglycemia.

Purpose of the Study:

To review the incidence and pathophysiological mechanisms of drug-induced hypoglycemia.
To discuss the prevention and management strategies for drug-induced hypoglycemia.
To highlight the clinical significance of drug-induced hypoglycemia, particularly in diabetic patients.

Main Methods:

Review of pertinent clinical information on drug-induced hypoglycemia.
Discussion of underlying pathophysiological mechanisms.
Analysis of prevention and management strategies.

Main Results:

Drugs are a frequent cause of hypoglycemia in adults, encompassing both antidiabetic and non-antidiabetic agents.
Mechanisms include enhanced insulin release, reduced insulin clearance, impaired glucose metabolism, and potentiation of antidiabetic effects.
Drug-induced hepatotoxicity, nephrotoxicity, and pancreatitis are additional contributing factors.

Conclusions:

Drug-induced hypoglycemia, ranging from mild to severe, necessitates clinical awareness for effective management.
Understanding the diverse mechanisms is crucial for preventing and treating this adverse drug reaction.
Proactive identification and management are essential, especially in patients with diabetes mellitus.