title: Hypoglycemia associated with phenytoin intoxication.
abstract: BACKGROUND
  Diphenylhydantoin, a widely used antiepileptic agent, can alter carbohydrate tolerance, and acute intoxication with diphenylhydantoin can be associated with hyperglycemia.
  
  
  METHODS
  We describe a patient who experienced a prolonged episode of hypoglycemia secondary to an acute voluntary intoxication with diphenylhydantoin 20 g and zopiclone 225 mg. This hypoglycemic episode was presumptively attributed to diphenylhydantoin and might be due either to an escape from the inhibitory effects of diphenylhydantoin on insulin secretion or an increased sensitivity of the tissues to insulin. Zopiclone was considered less likely since zopiclone overdoses have been only exceptionally associated with hyperglycemia.
authors.affiliation: Erasme University Hospital, Free University of Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Manto
authors.forename: J C
authors.initials: JC
authors.lastname: Preiser
authors.forename: J L
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000506:poisoning*; D053961:Azabicyclo Compounds; D001786:Blood Glucose / Q000032:analysis; D050260:Carbohydrate Metabolism; D005947:Glucose / Q000494:pharmacology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000506:poisoning; D007003:Hypoglycemia / Q000139:chemically induced*; D008297:Male; D010672:Phenytoin / Q000506:poisoning*; D010879:Piperazines / Q000506:poisoning; D013997:Time Factors
chemical_list: D000927:Anticonvulsants; D053961:Azabicyclo Compounds; D001786:Blood Glucose; D006993:Hypnotics and Sedatives; D010879:Piperazines; C515050:zopiclone; D010672:Phenytoin; D005947:Glucose