Hypoglycemic coma induced by inadvertent administration of glyburide

A 79-year-old nondiabetic woman was inadvertently given a 5-mg tablet of glyburide. Blood glucose concentration was 2.6 mmol/L three hours after ingestion. The patient was discharged 9 hours after ingestion and readmitted 10 1/2 hours after ingestion, in a hypoglycemic coma (blood glucose, 0.65 mmol/L). She was treated with two bolus doses of dextrose and intravenous dextrose. Her blood glucose was abnormal until hospital day 3. On hospital day 4, she was discharged with no apparent sequelae. This patient's severe reaction may have been due to mild renal insufficiency or concurrent use of timolol. Should inadvertent administration of glyburide occur in a patient with impaired renal function, the patient should be monitored for at least 24 hours.