The relationship between risk of hypoglycemia and use of cibenzoline and disopyramide.
OBJECTIVE
A case-control study was carried out to compare the risks of hypoglycemia caused by disopyramide and cibenzoline.


METHODS
We selected 91 subjects with hypoglycemia from among 14,156 outpatients who consulted the National Cardiovascular Center (NCVC) and received drug therapy between September 1997 and February 1998. We used the fasting blood sugar (FBS) level of 75 mg/dl or less as the cut-off level to screen for hypoglycemia. For each case, five controls matched for gender and age were selected from the clinical division consulted by relevant subjects.


RESULTS
Ninety-one cases and 455 controls were enrolled in this study. Of 91 cases with hypoglycemia, 8 (8.8%) were treated with cibenzoline and 3 (3.3%) with disopyramide. The percentage of cases treated with cibenzoline was greater than that in the controls (1.5%), and the prescription frequency of cibenzoline during the study period was 2%. With adjustment for potential confounding factors using conditional logistic regression, hypoglycemia was significantly correlated with the use of cibenzoline [OR 8.0 (95% CI 1.7-36.8)], insulin [OR 48.4 (95% CI 8.8-267.2)], and thyroid agents [OR 13.0 (95% CI 1.1-160.4)]. An increased risk of hypoglycemia associated with the use of sulfonylureas was not detected. In additional logistic regression analysis, including the variables with individual sulfonylureas, glibenclamide but not gliclazide significantly increased the risk of hypoglycemia. The use of disopyramide did not affect the risk of hypoglycemia. In separate analyses for diabetic and non-diabetic patients, the risks of hypoglycemia associated with the use of drugs other than beta-blocking agents in non-diabetic patients were estimated to be lower than those in diabetic patients.


CONCLUSIONS
The use of cibenzoline was significantly correlated with an increased risk of hypoglycemia.
Takada
M
M
Department of Pharmacy, National Cardiovascular Center, Suita-city, Osaka, Japan. takadam@ncvc.hosp.go.jp
Fujita
S
S
Katayama
Y
Y
Harano
Y
Y
Shibakawa
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001786:Blood Glucose / Q000187:drug effects; D016022:Case-Control Studies; D004206:Disopyramide / Q000009:adverse effects*; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007093:Imidazoles / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D026902:Potassium Channel Blockers; D013453:Sulfonylurea Compounds / Q000009:adverse effects
D000889:Anti-Arrhythmia Agents; D001786:Blood Glucose; D007093:Imidazoles; D026902:Potassium Channel Blockers; D013453:Sulfonylurea Compounds; D004206:Disopyramide; C032151:cifenline