title: Safety and tolerability of diazoxide in Japanese patients with hyperinsulinemic hypoglycemia.
abstract: Diazoxide is a non-diuretic benzothiadiazine derivative, one of a group of substances introduced into clinical practice in the 1950s for the treatment of hypertension. Fajans reported the use of diazoxide for the treatment of insulinoma in 1979. Although patients with hyperinsulinemic hypoglycemia worldwide have been treated with diazoxide for more than 30 years, there are no recent reports about the adverse effects of this drug in Asian patients, including Japanese patients. Herein, we report the results of our retrospective clinical record review of 6 Japanese patients (3 females and 3 males, ranging in age from 58 to 91 years) with hyperinsulinemic hypoglycemia and inoperable insulinoma treated with diazoxide. Diazoxide improved control of hypoglycemic symptoms and maintained normoglycemia in 5 of the 6 patients, and was ineffective in one patient. Surprisingly, although all 6 patients received diazoxide according to the treatment strategy recommended in Western patients, 5 of the 6 patients developed edema and two developed congestive heart failure. Thus, when starting treatment with diazoxide in Japanese patients, the symptoms and signs of fluid retention should be evaluated carefully. Also, appropriate protocols for treatment with diazoxide should be evaluated by means of clinical trials in Japanese patients with hyperinsulinemic hypoglycemia.
authors.affiliation: Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Komatsu
authors.forename: Akinobu
authors.initials: A
authors.lastname: Nakamura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takihata
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Satoko
authors.initials: S
authors.lastname: Yahagi
authors.forename: Kazuki
authors.initials: K
authors.lastname: Tajima
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Tsuchiya
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Takano
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yamakawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyoshi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terauchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003981:Diazoxide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016903:Drug Monitoring; D004351:Drug Resistance; D004487:Edema / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology / Q000517:prevention & control*; D007003:Hypoglycemia / Q000209:etiology / Q000517:prevention & control*; D007340:Insulinoma / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D007564:Japan; D008297:Male; D008875:Middle Aged; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents; D003981:Diazoxide