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Phenytoin-induced hyperglycemia

B L Carter, R E Small, M D Mandel

American Journal of Hospital Pharmacy

|October 1, 1981

Summary

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Phenytoin, an anti-seizure medication, may cause hyperglycemia (high blood sugar) in patients with diabetes. This case highlights the importance of considering drug-induced hyperglycemia in diabetic patients experiencing elevated blood glucose levels.

Area of Science:

Endocrinology
Neurology

Background:

Phenytoin is an anti-seizure medication.
Diabetic ketoacidosis is a serious complication of diabetes.

Observation:

A 64-year-old woman with type 2 diabetes developed diabetic ketoacidosis while taking phenytoin for seizures.
Her seizures were thought to be secondary to a prior episode of nonketotic hyperosmolar coma.

Findings:

Phenytoin therapy was initiated six weeks prior to admission.
The patient's hyperglycemia resolved after discontinuing phenytoin and receiving standard treatment for diabetic ketoacidosis.

Implications:

This case suggests a potential link between phenytoin and hyperglycemia.
Clinicians should consider drug-induced hyperglycemia in patients taking phenytoin, especially those with diabetes.

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Further research into the mechanisms of phenytoin-induced hyperglycemia is warranted.