Hypoglycemia after administration of somatostatin analog (SMS 201-995) in metastatic carcinoid.
SMS 201-995 (Sandoz Pharmaceuticals, East Hanover, NJ) is a synthetic peptide analog of native somatostatin that has been used to relieve symptoms caused by neuroendocrine tumors. Reports have described an insulin suppressive effect of SMS 201-995 that results in elevations of blood glucose. We report a patient with a metastatic small bowel carcinoid and renal failure in whom mild symptomatic hypoglycemia occurred 30 to 60 minutes after SMS 201-995 administration. No increase in insulin or decreases in glucagon, cortisol, or catecholamines were observed during these hypoglycemic episodes. Elevated levels of growth hormone fell gradually following SMS 201-995 administration and did not temporally correspond to the 30- to 60-minute nadir of blood glucose. However, SMS 201-995 levels peaked during this 30- to 60-minute period. As clinical experience with this drug broadens, patients whose glucose control is dependent on counter-regulatory hormones should be monitored for the possibility of hypoglycemia.
Brunner
J E
JE
Kruger
D F
DF
Basha
M A
MA
Meiri
E
E
Kaatz
S S
SS
D000368:Aged; D002276:Carcinoid Tumor / Q000503:physiopathology*; D003967:Diarrhea / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007414:Intestinal Neoplasms / Q000503:physiopathology*; D015282:Octreotide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D015282:Octreotide