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Mefloquine-associated hypoglycaemia in a cachectic AIDS patient
R Assan1, C Perronne, L Chotard
1Diabetes Dpt., Hôpital Bichat, Paris, France.
Diabete & Metabolisme
|February 1, 1995
Summary
Mefloquine, an anti-malarial drug, can cause severe hypoglycemia by increasing insulin secretion, even in patients without a history of this adverse effect. This risk is particularly relevant for cachectic individuals with prolonged diarrhea.
Area of Science:
- Pharmacology
- Endocrinology
- Infectious Diseases
Background:
- Quinine and quinidine are known to induce hypoglycemia through excessive insulin secretion.
- The hypoglycemic potential of other quinine analogues, like mefloquine, remains less understood.
- Adverse effects of mefloquine, particularly hypoglycemia, have not been previously documented.
Observation:
- A case of severe hypoglycemia (2.3 mmol/l) occurred in an AIDS patient after mefloquine treatment for cryptosporidiasis.
- Blood glucose levels normalized with intravenous glucose infusion and did not recur despite continued mefloquine therapy.
- In vitro studies demonstrated that mefloquine stimulates insulin secretion from rat islets of Langerhans.
Findings:
- Mefloquine can induce significant hypoglycemia, likely by directly stimulating insulin secretion from pancreatic beta cells.
- This adverse effect was observed in a cachectic AIDS patient with severe gastrointestinal symptoms.
- In vitro experiments confirmed mefloquine's capacity to enhance insulin release.
Implications:
- Clinicians should consider the risk of severe hypoglycemia in cachectic patients receiving mefloquine, especially those with prolonged diarrhea.
- Awareness of this potential adverse effect is crucial for managing patients on mefloquine therapy.
- Further research into the mechanisms and risk factors for mefloquine-induced hypoglycemia is warranted.