Extended-release glipizide overdose presenting with delayed hypoglycemia and treated with subcutaneous octreotide.
The onset of symptomatic hypoglycemia in children with ingestions of second-generation sulfonylureas has never been documented to be later than 21 hours post-ingestion. We report a case with the longest known interval, 45 hours, between ingestion of a sulfonylurea and the onset of hypoglycemia requiring medical intervention. The hypoglycemia was severe and required multiple dextrose boluses in addition to continuous dextrose infusion for 36 hours. This patient was also treated with multiple doses of subcutaneous octreotide because of persistent hypoglycemia despite the above management. This case represents the first report of subcutaneous octreotide used as a treatment for pediatric hypoglycemia secondary to sulfonylurea exposure.
Pelavin
Paul I
PI
Department of Pediatrics, Valley Health System, The Valley Hospital, Ridgewood, NJ, USA.
Abramson
Erika
E
Pon
Steven
S
Vogiatzi
Maria G
MG
D002648:Child; D062787:Drug Overdose; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D005913:Glipizide / Q000009:adverse effects*; D005947:Glucose / Q000494:pharmacology; D006801:Humans; D006946:Hyperinsulinism / Q000188:drug therapy* / Q000209:etiology; D007003:Hypoglycemia / Q000188:drug therapy* / Q000209:etiology; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007279:Injections, Subcutaneous; D015282:Octreotide / Q000627:therapeutic use*; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D007004:Hypoglycemic Agents; D005947:Glucose; D015282:Octreotide; D005913:Glipizide