title: Characteristics of patients with sulphonurea-induced hypoglycemia.
abstract: OBJECTIVE
  Sulphonylurea (SU) agents continue to be a cornerstone of the therapy of type 2 diabetes mellitus (T2DM). Hypoglycemia is the most dangerous side effect of SU. Identifying the characteristics of patients with SU-induced hypoglycemia (SUIH) may help in reducing its frequency.
  
  
  METHODS
  All consecutive admissions of patients with SUIH, between 2000 and 2008, were retrospectively reviewed.
  
  
  RESULTS
  Over the study period, 4702 patients with type 2 diabetes mellitus were admitted to the department of medicine. Of these, 155 patients were admitted because of SUIH. Most of these patients were elderly, had multiple comorbid situations, and were taking multiple medications. Almost a third of the patients had a history of recent changes in the use of their medications. Various infectious complications (urinary, lung, skin, and peritoneal) occurred in 43% of patients. Renal failure was a frequent finding at admission (44% of patients had creatinine plasma levels > 120 μmol/L). Poor oral intake before admission was reported by 31% of patients. Markers of malnutrition (low serum levels of albumin, iron, vitamin B-12, and folic acid) were frequently found in most patients. Mean hemoglobin A1C levels were in the low abnormal levels. A major vascular event during hospitalization co-occurred in 11% of patients. Three patients died during the hospital admission for SUIH.
  
  
  CONCLUSIONS
  Elderly fragile patients with multiple comorbid situations including renal failure and tight glycemic control are prone to develop SUIH. Sulphonylurea agents should be avoided in such patients. An episode of SUIH should be considered as an alarming prognostic marker.
authors: Department of Medicine, Hadassah-Hebrew University, Medical Center, Mount Scopus Campus, Jerusalem, Israel.
authors: Yael Dinur
authors: YD
authors: Schejter
authors: Elliot
authors: E
authors: Turvall
authors: Zvi
authors: Z
authors: Ackerman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy; D004347:Drug Interactions; D005260:Female; D038321:Glycemic Index / Q000187:drug effects; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000453:epidemiology / Q000517:prevention & control; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D051437:Renal Insufficiency; D012189:Retrospective Studies; D013453:Sulfonylurea Compounds / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D013453:Sulfonylurea Compounds