Drug-Induced Hypoglycemia

A number of drugs apart from the sulfonylureas can occasionally cause hypoglycemia, especially when ingested in large amounts. These include quinine, quinidine, disopyramide, and salicylates. ACE inhibitors, when taken with antidiabetic drugs, can cause hypoglycemia possibly by improving insulin sensitivity.

Recently, it has been reported that the use of gatifloxacin in diabetic patients is associated with serious hypoglycemic and hyperglycemic reactions.

Ten to 20 percent of patients receiving pentamidine for Pneumocystis jiroveci pneumonia develop symptomatic hypoglycemia, particularly when the drug is administered intravenously.

This apparently is due to lytic destruction of pancreatic B cells, causing acute hyperinsulinemia and hypoglycemia.

It is later followed by insulinopenia and hyperglycemia, which occasionally is persistent. Since other drugs have been found to be as effective in treating Pneumocystis pneumonia, pentamidine administration and its hypoglycemic sequelae are less frequently encountered.

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