Inadequate adrenergic response to disopyramide-induced hypoglycemia.
OBJECTIVE
To report a case of disopyramide-induced hypoglycemia and to discuss the observed inadequate adrenergic response in this patient. Risk factors, possible etiologies, and preventive measures are also discussed.


METHODS
References from case reports and review articles as identified by MEDLINE.


RESULTS
A wide variety of drugs has been implicated as causing hypoglycemia. The mechanism for drug-induced hypoglycemia is known for the majority of these agents. Case reports of disopyramide-induced hypoglycemia have been reported in the literature, but the mechanism of action is unclear. We report a case of disopyramide-induced hypoglycemia in which counter-regulatory hormones, serum insulin, and C-peptide concentrations were obtained. From these data, it appears that disopyramide-induced hypoglycemia results from endogenous insulin secretion, with concomitant inadequate counterregulatory response.


CONCLUSIONS
Although a rare occurrence, disopyramide-induced hypoglycemia is potentially life-threatening. Patients at risk for this reaction need to be identified prior to the institution of disopyramide therapy. Patients at risk for hypoglycemia should be monitored while on disopyramide and disopyramide blood concentrations should be maintained at the lower end of the therapeutic range, or alternative agents should be considered.
Smith
R C
RC
University of Southern California, San Diego.
Sullivan
M
M
Geller
J
J
D000368:Aged; D002096:C-Peptide / Q000097:blood; D004206:Disopyramide / Q000009:adverse effects*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D007328:Insulin / Q000097:blood; D008297:Male
D002096:C-Peptide; D007328:Insulin; D004206:Disopyramide