Drug-induced hypoglycaemia in type 2 diabetes.
BACKGROUND
Hypoglycaemia is a side effect caused by some therapies for type 2 diabetes, which can cause physical, social and psychological harm. Hypoglycaemia also prevents attainment of treatment goals and satisfactory glycaemic control.


METHODS
The risk of hypoglycaemia associated with commonly prescribed therapies, including metformin, sulphonylureas, dipeptidyl peptidase-4 enzyme (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) agonists and thiazolidinediones, is reviewed in this paper (insulin-induced hypoglycaemia is not included). Other medications that are frequently co-prescribed in type 2 diabetes are also discussed, including anti-hypertensive drugs, antibiotics and fibrates, along with various important patient-related risk factors.


CONCLUSIONS
Hypoglycaemia is a common and potentially dangerous side effect of some medications used for type 2 diabetes. The risk of hypoglycaemia should always be considered when selecting and implementing a therapy, with a focus on the individual. Future research into new therapies should measure the frequency of hypoglycaemia prospectively and accurately. Hypoglycaemia has been shown to be a potentially life-threatening metabolic stress; therefore therapies that effectively manage diabetes without the risk of hypoglycaemia are likely to be favoured in the future.
Royal Infirmary of Edinburgh, Department of Diabetes, 51 Little France Crescent, Edinburgh, EH16 4SA, UK.
Berit
B
Inkster
Nicola N
NN
Zammitt
Brian M
BM
Frier
D000218:Adamantane / Q000009:adverse effects / Q000031:analogs & derivatives; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004151:Dipeptides / Q000009:adverse effects; D000077270:Exenatide; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D008687:Metformin / Q000009:adverse effects; D010455:Peptides / Q000009:adverse effects; D010597:Pharmacogenetics; D000077205:Pioglitazone; D013453:Sulfonylurea Compounds / Q000009:adverse effects; D045162:Thiazolidinediones / Q000009:adverse effects; D014688:Venoms / Q000009:adverse effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D004151:Dipeptides; D007004:Hypoglycemic Agents; D010455:Peptides; D013453:Sulfonylurea Compounds; D045162:Thiazolidinediones; D014688:Venoms; D008687:Metformin; C502994:saxagliptin; D000077270:Exenatide; D000218:Adamantane; D000077205:Pioglitazone