Clinically significant diuretic-induced glucose intolerance.
Diuretic-induced glucose intolerance is cited frequently as a problem of only limited clinical significance. In certain populations, such as Mexican-Americans, this effect may be much more dramatic. A 50-year-old obese Mexican-American woman presented with a three-month history of increased thirst and frequent urination. A fasting blood glucose concentration of 365 mg/dL prompted initiation of chlorpropamide therapy. A review of her medical history revealed that a thiazide diuretic was started six months previously. A reduction in thiazide dose and potassium supplementation together with chlorpropamide therapy controlled the patient's blood glucose. Subsequently, all three medications were discontinued, and the patient remained normoglycemic during a full year of follow-up. The temporal relationship between symptomatic diabetes and hydrochlorothiazide therapy incriminates the diuretic as the most probable cause.
Lowder
N K
NK
College of Pharmacy, UTHSCSA-Department of Pharmacology, San Antonio 78284.
Bussey
H I
HI
Sugarek
N J
NJ
D001581:Benzothiadiazines; D001786:Blood Glucose / Q000378:metabolism; D004232:Diuretics / Q000009:adverse effects*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects
D001581:Benzothiadiazines; D001786:Blood Glucose; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D011188:Potassium