Supratherapeutic doses of sulfonylureas in diabetic patients: how much is too much?
BACKGROUND
Determining triage guidelines for supratherapeutic ingestions of sulfonylureas is difficult because they have broad therapeutic indexes. This study was performed to evaluate the degree of hypoglycemia that may result from a supratherapeutic ingestion of a sulfonylurea in a diabetic patient.


METHODS
Poison center records over a 3-year period were retrospectively reviewed for cases of adults acutely ingesting supratherapeutic doses of sulfonylureas (SFU).


RESULTS
A total of 85 cases were identified. Eight patients had complaints of shakiness or dizziness, but no patient developed symptoms refractory to oral glucose/carbohydrate supplementation or required intravenous dextrose.


CONCLUSIONS
In our study, all diabetic patients accidentally ingesting more than their usual single dose (USD) or usual daily dose (UDD) of their SFU were safely monitored at home while observing for subjective or objective signs of hypoglycemia. When necessary, oral dextrose could be administered in these patients at home.
Cantrell
F Lee
FL
California Poison Control System, San Diego Division, San Diego, California, USA. fcantrel@ucsd.edu
Clark
Richard F
RF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy*; D062787:Drug Overdose; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011039:Poison Control Centers; D013453:Sulfonylurea Compounds / Q000009:adverse effects*
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D005947:Glucose