scholarly journals A case of severe relapsing sulphonylurea-induced hypoglycaemia

2019 ◽  
Vol 12 (12) ◽  
pp. e231368 ◽  
Author(s):  
Simon Mifsud ◽  
Emma Louise Schembri ◽  
Stephen Fava
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Renal Function ◽  
Impaired Renal Function ◽  
Hypoglycaemic Event ◽  
Increased Risk ◽  
Prolonged Effect ◽  
Prolonged Observation

The authors report a case of a 64-year-old woman who was diagnosed with severe relapsing sulphonylurea-induced hypoglycaemia. Sulphonylureas are frequently used in patients with type 2 diabetes mellitus. They promote insulin secretion independent of the prevailing glucose level and thus are associated with an increased risk of hypoglycaemia. In patients with adequate renal function, gliclazide’s effect lasts 10–24 hours and it is usually completely eliminated within 144 hours postdose. Since our patient suffered from chronic kidney disease, gliclazide’s effect was prolonged and she was experiencing spontaneous hypoglycaemic episodes up to 21 days postomission of gliclazide. This case highlights two important aspects. Primarily, the prolonged effect of sulphonylureas in patients with impaired renal function, hence highlighting the need to be cautious prior to prescribing sulphonylureas in such patients. Secondly, the importance of prolonged observation of patients on sulphonylureas even after the initial hypoglycaemic event is corrected, due to the extended effects of such drugs.

Risk factors for development of impaired renal function in Type 2 diabetes mellitus patients in primary care

2004 ◽  
Vol 21 (10) ◽  
pp. 1096-1101 ◽  
Author(s):  
M. J. Naushahi ◽  
W. J. C. de Grauw ◽  
A. J. Avery ◽  
W. H. E. M. van Gerwen ◽  
E. H. van de Lisdonk ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Renal Function ◽  
Impaired Renal Function

scholarly journals Type 2 Diabetes Mellitus and Impaired Renal Function Are Associated With Brain Alterations and Poststroke Cognitive Decline

Stroke ◽  
2017 ◽  
Vol 48 (9) ◽  
pp. 2368-2374 ◽  
Author(s):  
Einor Ben Assayag ◽  
Roy Eldor ◽  
Amos D. Korczyn ◽  
Efrat Kliper ◽  
Shani Shenhar-Tsarfaty ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Function ◽  
Cognitive Decline ◽  
Impaired Renal Function

scholarly journals PROGRESSING CHRONIC KIDNEY DISEASE AND THE 12-MONTH DYNAMICS OF CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS

2013 ◽  
Vol 12 (5) ◽  
pp. 16-21
Author(s):  
A. V. Markova ◽  
Yu. G. Schwartz
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Renal Function ◽  
Cardiovascular Risk ◽  
Medical History ◽  
Ckd Stage

Aim. To assess the association between the 12-month dynamics of cardiovascular risk factors (CVD RFs), progressing chronic kidney disease (CKD), and individual baseline clinical and laboratory parameters in patients with arterial hypertension (AH) and Type 2 diabetes mellitus (DM-2) who received active antidiabetic treatment.Material and methods. In total, 122 patients with AH and DM-2 underwent the laboratory assessment of blood and urine samples at baseline and 12 months later, in order to evaluate the levels and dynamics of CVD RFs and CKD severity.Results. After 12 months of continuous therapy with antihypertensive and oral antidiabetic medications and statins, the carbohydrate metabolism parameters significantly improved. However, creatinine clearance decreased significantly (by 7,52%). The direction of renal function parameter changes was determined by the baseline CKD stage. Progressing CKD was also associated with obesity (O), atrial fibrillation (AF), and myocardial infarction (MI) in medical history. In patients with or without O, the albumin-creatinine ratio decreased by 59,8% and 34%, respectively. In participants with or without AF, microalbuminuria increased by 321% and decreased by 53,5%, respectively. In patients with MI in medical history, urine levels of creatinine decreased by 33,6%, while in the other patients, they increased by 5,4%. O was associated with a reduction in total cholesterol (TCH) by 5,5%, while in non-obese patients, TCH levels did not change substantially.Conclusion. In most patients with AH and DM-2, adequate glycemia control, standard antihypertensive treatment, and statin therapy for 12 months were associated with minimal changes in CVD RFs and with a significant deterioration in renal function. The latter was predicted by the CKD stage at baseline, O, MI in medical history, and AF. 

scholarly journals Hypoglycaemia is associated with increased risk of fractures in patients with type 2 diabetes mellitus: a cohort study

2019 ◽  
Vol 180 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Antiopi Ntouva ◽  
Konstantinos A Toulis ◽  
Deepikshana Keerthy ◽  
Nicola J Adderley ◽  
Wasim Hanif ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Risk Factor ◽  
Cohort Study ◽  
Secondary Outcome ◽  
Health Improvement ◽  
Hypoglycaemic Event ◽  
Increased Risk

Objective Type 2 diabetes is associated with an increased risk of fracture. Any factor that incrementally increases this risk should be taken into account when individualising treatment. Hypoglycaemia is a common complication of antidiabetes medications and suggested as a risk factor for fractures; yet, its real-life clinical impact is unclear. Design A population-based, retrospective open cohort study using routinely collected data between 1st of January 1995 and 1st of May 2016 in The Health Improvement Network (THIN) database. Methods Patients with type 2 diabetes mellitus with documented hypoglycaemic events were compared to randomly matched patients with type 2 diabetes mellitus without documented hypoglycaemic events matched to exposed patients on age, sex, duration of diabetes and BMI. The primary outcome was any incident fracture. Secondary outcome was incident fragility (osteoporotic) fracture. Results A total of 41 163 patients with type 2 diabetes were included: 14 147 patients in the exposed cohort and 27 016 patients in the unexposed cohort. Patients with a documented hypoglycaemic event were significantly more likely to sustain any fracture compared to patients with no record of hypoglycaemic events: adjusted IRR = 1.20 (95% CI: 1.12–1.30; P < 0.0001). Patients who had a documented hypoglycaemic event were significantly more likely to suffer a fragility fracture compared to controls: adjusted IRR = 1.24 (95% CI: 1.13–1.37; P < 0.0001). Conclusions Hypoglycaemic events are a significant risk factor for fractures in patients with diabetes mellitus. This observation is clinically relevant when individualising targets for glycaemic control and selecting antidiabetic agents.

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