title: [Detection of glimepiride and rosiglitazone from Chinese dietary supplements].
abstract: A 79-year-old man with diabetes mellitus developed prolonged hypoglycemia. The patient had ingested two Chinese dietary supplements in addition to his prescribed nateglinide (Fastic). Using liquid chromatography tandem mass spectrometry, glimepiride from sulfonylurea, as well as rosiglitazone from a thiazolidine derivative, were detected in the Chinese dietary supplements, which were then quantitatively analyzed using liquid chromatography with UV detector. Mean values (n=3) of glimepiride contents of the Chinese dietary supplements were 0.75 and 0.86 mg/capsule. Predicted intake of glimepiride in the patient was estimated to be 4.8-8.2 mg/day according to the glimepiride contents and directions of the Chinese dietary supplements. The daily intake of glimepiride in this patient was greater than daily maintenance doses (1-4 mg) of glimepiride for diabetic patients. Therefore, overdose of glimepiride by ingestion of the Chinese dietary supplements appears to be associated with the development of prolonged hypoglycemia.
authors.affiliation: Poisoning and Drug Laboratory Division, Critical Care and Emergency Center, Iwate Medical University Hospital.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fujita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Honma
authors.forename: Jo
authors.initials: J
authors.lastname: Satoh
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujino
authors.forename: Makoto
authors.initials: M
authors.lastname: Onodera
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Shigeatsu
authors.initials: S
authors.lastname: Endo
mesh_terms: D000368:Aged; D002681:China; D002853:Chromatography, Liquid; D019587:Dietary Supplements / Q000009:adverse effects* / Q000032:analysis*; D062787:Drug Overdose; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000032:analysis*; D008297:Male; D000077154:Rosiglitazone; D013453:Sulfonylurea Compounds / Q000009:adverse effects* / Q000032:analysis*; D053719:Tandem Mass Spectrometry; D045162:Thiazolidinediones / Q000009:adverse effects* / Q000032:analysis*
chemical_list: D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D045162:Thiazolidinediones; D000077154:Rosiglitazone; C057619:glimepiride