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Closet hypoglycemia

I Robinson1, R L Deamer, J G Prichard

  • 1Department of Family Medicine, Ventura County Medical Center, California 93003.

The Journal of Family Practice
|January 1, 1994
PubMed
Summary
This summary is machine-generated.

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A medication mix-up caused severe hypoglycemia in an elderly woman. Chlorpropamide, a sulfonylurea drug, was mistaken for a nonsteroidal anti-inflammatory drug (NSAID), leading to dangerously low blood glucose levels.

Area of Science:

  • Endocrinology
  • Geriatric Medicine
  • Clinical Pharmacology

Background:

  • Unexplained severe hypoglycemia can be a serious medical emergency, particularly in elderly patients.
  • Accurate medication history is crucial for diagnosing metabolic disturbances.
  • Sulfonylureas are a class of oral hypoglycemic agents known to cause prolonged hypoglycemia.

Observation:

  • An elderly, nondiabetic woman presented with stupor and unresponsiveness.
  • Emergency department testing revealed a serum glucose level of 40 mg/dL (2.2 mmol/L).
  • No intrinsic metabolic derangement was identified as the cause.

Findings:

  • A medication sample bottle, mislabeled as a nonsteroidal anti-inflammatory drug (NSAID), was found to contain chlorpropamide tablets.

Related Experiment Videos

  • The patient's severe hypoglycemia was attributed to accidental ingestion of chlorpropamide.
  • This highlights the potential for medication errors to cause profound metabolic effects.

    • Implications:

    • Healthcare providers must consider sulfonylureas as a potential cause of unexplained severe hypoglycemia.
    • Vigilance in medication reconciliation and dispensing is essential to prevent such adverse events.
    • This case underscores the importance of thorough medication review in emergency settings, especially in elderly patients.