Octreotide for sulfonylurea-induced hypoglycemia following overdose

OBJECTIVE: To describe the use of octreotide in the management of 2 cases of sulfonylurea-induced hypoglycemia following overdose and to review the literature on the use of octreotide in the management of sulfonylurea overdose. CASE SUMMARY: Case 1 describes a 27-year-old woman who ingested 500 mg of glyburide; case 2 describes a 22-year-old woman following ingestion of glyburide 1000 mg. Despite administration of bolus doses of dextrose 50% and infusions of dextrose 10%, both patients demonstrated refractory hypoglycemia. Three doses of octreotide 50 micro g were administered subcutaneously spaced 8 hours apart to both patients, resulting in a reduction of hypoglycemic episodes and a reduced need for dextrose administration. DISCUSSION: In addition to the 2 cases described, 8 citations involving 23 patients with sulfonylurea overdose in which octreotide was used were identified in the literature. As with our patients, episodes of hypoglycemia and the need for bolus doses of dextrose 50% were reduced following administration of octreotide. CONCLUSIONS: The use of octreotide appears to reduce the number of hypoglycemic episodes and glucose requirements, with no reported toxicities associated with its use for sulfonylurea-induced hypoglycemia following overdose.

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