title: Sunitinib-induced severe hypoglycemia in a diabetic patient.
abstract: BACKGROUND
  Sunitinib is an oral inhibitor of tyrosine kinase that was used for the treatment of mRCC. The general side effects are fatigue, asthenia, diarrhea, mucositis, nausea, vomiting, skin changes, hypertension, hypothyroidism and hematologic side effects. In addition, sunitinib-induced hypoglycemia has also been reported. There are limited number of case reports related to sunitinib-induced hypoglycemia.
  
  
  METHODS
  In this case report, we have presented a patient with type 2 diabetes mellitus (DM) with emerging severe hypoglycemia after sunitinib treatment. It was shown that blood glucose levels were normalized two weeks after the interruption of sunitinib.
  
  
  CONCLUSIONS
  Although the underlying mechanism of sunitinib-induced hypoglycemia is not completely understood, sunitinib can be regarded to have an antidiabetic effect. In the literature, there are some reports about sunitinib/other TKI induced hypoglycemia; however, life threatening hypoglycemia is rare. There is no case report of severe hypoglycemia due to imatinib; however, there are two case reports with severe hypoglycemia due to sunitinib treatment. Symptomatic hypoglycemic episodes due to sunitinib may lead to hospital admission. Diabetic patients may develop severe hypoglycaemia and it should be kept in mind that the discontinuation of antihyperglycemic treatment may be required. Therefore, blood glucose levels should be closely monitored in diabetic patients with mRCC during sunitinib therapy.
authors.affiliation: Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey aaysedemirci@gmail.com.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Demirci
authors.affiliation: Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Oznur
authors.initials: O
authors.lastname: Bal
authors.affiliation: Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Ayşe
authors.initials: A
authors.lastname: Durnali
authors.affiliation: Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Ahmet Ş
authors.initials: AŞ
authors.lastname: Ekinci
authors.affiliation: Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Eşbah
authors.affiliation: Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Necati
authors.initials: N
authors.lastname: Alkiş
authors.affiliation: Department of Medical Oncology, Ankara Oncology Education and Research Hospital, Ankara, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Oksüzoğlu
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000503:physiopathology; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use; D012720:Severity of Illness Index; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D001786:Blood Glucose; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib
keywords: Sunitinib; diabetes; hypoglycemia