Patient Case Report: Gabapentin-Induced Hypoglycemia

Area of Science:

• Pharmacology
• Neurology
• Endocrinology

Background:

• Gabapentin, an analog of gamma-aminobutyric acid (GABA), has an incompletely understood mechanism of action.
• Common gabapentin side effects include somnolence, sedation, and dizziness.
• While hyperglycemia is noted in labeling, case reports suggest hypoglycemia is also a potential adverse drug reaction.

Observation:

• A 47-year-old female presented with altered mental status and severe hypoglycemia (blood glucose 33 mg/dL).
• Gabapentin therapy was initiated one week prior to the hypoglycemic event.
• No other common causes for severe hypoglycemia were identified in her medical history or medication list.

Findings:

• The patient experienced a significant drop in blood glucose levels after starting gabapentin.
• The observed hypoglycemia was severe and presented with altered mental status.
• The case suggests a potential causal link between gabapentin and hypoglycemia in non-diabetic individuals.

Implications:

• Gabapentin's interaction with voltage-gated calcium channels, specifically the alpha2delta subunit in pancreatic cells, may contribute to hypoglycemia.
• This case highlights the importance of considering gabapentin as a potential cause of hypoglycemia, even in patients without diabetes.
• Further investigation into the glucose-lowering effects of gabapentin is warranted.