Severe and recurrent hypoglycemia in an elderly patient with type 2 diabetes: the role of Glibenclamide and urinary tract infection
Severe and recurrent hypoglycemia in type 2 diabetes
DOI:
https://doi.org/10.59747/smjidisurabaya.v2i2.81Kata Kunci:
type 2 diabetes mellitus, urinary tract infectionAbstrak
Background: Hypoglycemia is an acute complication of diabetes especially in elderly patients and a leading cause of emergency room visits and hospital admissions. Several risk factors, such as age, polypharmacy, inadequate food intake, and infections, can further increase the risk of recurrent hypoglycemia and complicate its management. Objective: This report aims to present a case of severe and recurrent hypoglycemia induced by Glibenclamide in an elderly patient with concurrent infection. Case: A 66-year-old female was admitted to the emergency department (ED) in an unconscious state. After a thorough history taking and examination, the patient was diagnosed with profound hypoglycemia induced by sulfonylurea and urinary tract infection. Recurrent episodes of hypoglycemia were observed during treatment despite the administration of Dextrose 40%. Conclusion: Severe hypoglycemia is a common and life-threatening complication. Glibenclamide is a known cause of severe hypoglycemia, although other risk factors may also contribute to its occurrence. Infections can exacerbate hypoglycemic episodes, making them more difficult to manage. Clinicians must remain vigilant about recurrent episodes of hypoglycemia as prompt treatment is associated with a good prognosis
Referensi
Abdelhafiz, A.H., Rodríguez-Mañas, L., Morley, J.E., Sinclair, A.J., 2015. Hypoglycemia in older people - A less well recognized risk factor for frailty. Aging Dis. 6, 156–167.
Aljumaidi, A.M., Albakri, J.K., Alnasr, A.A.A., Allehyani, A.F., 2024. The Incidence of Hypoglycemia and Its Risk Factors Among Diabetic Patients at Prince Mohammed bin Abdulaziz National Guard Hospital in Al-Madinah Al-Munawwarh, Saudi Arabia. South East. Eur. J. Public Heal. 25, 157–172.
Alsahli, M., Gerich, J.E., 2015. Hypoglycemia in patients with diabetes and renal disease. J. Clin. Med. 4, 948–964.
Amiel, S.A., Dixon, T., Mann, R., Jameson, K., 2008. Hypoglycaemia in Type 2 diabetes. Diabet. Med. 25, 245–254.
Asplund, K., Wiholm, B.E., Lithner, F., 1983. Glibenclamide-associated hypoglycaemia: A report on 57 cases. Diabetologia 24, 412–417.
Bolanle Ademolu, A., 2019. Sulfonylureas Induced Hypoglycemia in Diabetics - A Review. Int. J. Diabetes Endocrinol. 4, 108.
Casqueiro, Juliana, Casqueiro, Janine, Alves, C., 2012. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J. Endocrinol. Metab. 16, 27.
Chávez-Reyes, J., Escárcega-González, C.E., Chavira-Suárez, E., León-Buitimea, A., Vázquez-León, P., Morones-Ramírez, J.R., Villalón, C.M., Quintanar-Stephano, A., Marichal-Cancino, B.A., 2021. Susceptibility for Some Infectious Diseases in Patients With Diabetes: The Key Role of Glycemia. Front. Public Heal. 9, 1–18.
Elsayed, N.A., Aleppo, G., Aroda, V.R., Bannuru, R.R., Brown, F.M., Bruemmer, D., Collins, B.S., Cusi, K., Hilliard, M.E., Isaacs, D., Johnson, E.L., Kahan, S., Khunti, K., Leon, J., Lyons, S.K., Perry, M. Lou, Prahalad, P., Pratley, R.E., Seley, J.J., Stanton, R.C., Gabbay, R.A., 2023. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes—2023. Diabetes Care 46, S49–S67.
Emral, R., Sarı, R., Güler, S., 2018. Implication of findings from international studies on hypoglycemia for management of diabetes in insulin-treated patients in Turkey. Turkish J. Endocrinol. Metab. 22, 32–40.
Fisher, B.M., Gillen, G., Hepburn, D.A., Dargie, H.J., Frier, B.M., 1990. Cardiac responses to acute insulin-induced hypoglycemia in humans. Am. J. Physiol. - Hear. Circ. Physiol. 258.
Gangji, A.S., Cukierman, T., Gerstein, H.C., Goldsmith, C.H., Clase, C.M., 2007. A systematic review and meta-analysis of hypoglycemia and cardiovascular events: A comparison of glyburide with other secretagogues and with insulin. Diabetes Care 30, 389–394.
Geerlings, S., Fonseca, V., Castro-Diaz, D., List, J., Parikh, S., 2014. Genital and urinary tract infections in diabetes: Impact of pharmacologically-induced glucosuria. Diabetes Res. Clin. Pract. 103, 373–381.
Hölzen, L., Schultes, B., Meyhöfer, S.M., Meyhöfer, S., 2024. Hypoglycemia Unawareness—A Review on Pathophysiology and Clinical Implications. Biomedicines 12, 1–12.
Hussain, A., Ali, I., Khan, A.U., Khan, T.M., 2016. Glibenclamide-induced profound hypoglycaemic crisis: a case report. Ther. Adv. Endocrinol. Metab. 7, 84–87.
James, P.A., Oparil, S., Carter, B.L., Cushman, W.C., Dennison-Himmelfarb, C., Handler, J., Lackland, D.T., LeFevre, M.L., MacKenzie, T.D., Ogedegbe, O., Smith, S.C., Svetkey, L.P., Taler, S.J., Townsend, R.R., Wright, J.T., Narva, A.S., Ortiz, E., 2014. 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama 311, 507–520.
Kaaniche, F.M., Allala, R., Nasri, A.B., Smaoui, M.M.A.E.T.M., 2022. Hypoglycemia in emergencies: factors predicting hospitalization A multivariate analysis of 43 cases. J.I. M. Sfax 41, 33–40.
Kewcharoenwong, C., Rinchai, D., Utispan, K., Suwannasaen, D., Bancroft, G.J., Ato, M., Lertmemongkolchai, G., 2013. Glibenclamide reduces pro-inflammatory cytokine production by neutrophils of diabetes patients in response to bacterial infection. Sci. Rep. 3, 1–8.
Kim, T.M., Kim, H., Lee, S.H., Cho, J.H., Lee, H., Yim, H.W., Yoon, K.H., Kim, H.S., 2020. Characteristics of Hypoglycemic Diabetic Patients Visiting the Emergency Room. Cardiovasc. Ther. 2020, 3612607.
Lin, Y.Y., Hsu, C.W., Sheu, W.H.H., Chu, S.J., Wu, C.P., Tsai, S.H., 2010. Risk factors for recurrent hypoglycemia in hospitalized diabetic patients admitted for severe hypoglycemia. Yonsei Med. J. 51, 367–374.
Nakhleh, A., Shehadeh, N., 2021. Hypoglycemia in diabetes: An update on pathophysiology, treatment, and prevention. World J. Diabetes 12, 2036–2049.
Nitzan, O., Elias, M., Chazan, B., Saliba, W., 2015. Urinary tract infections in patients with type 2 diabetes mellitus: Review of prevalence, diagnosis, and management. Diabetes, Metab. Syndr. Obes. 8, 129–136.
Rani, M., Yadav, S., Choudhary, S., Sharma, S., Pandey, S.M., 2014. Incidence of Hypoglycemia and Other Side Effects in Patients of Type 2 Diabetes Mellitus Treated with Glimpiride versus Glibenclamide. Int. J. Heal. Sci. Res. 4, 68–72.
Salari, N., Karami, M.M., Bokaee, S., Chaleshgar, M., Shohaimi, S., Akbari, H., Mohammadi, M., 2022. The prevalence of urinary tract infections in type 2 diabetic patients: a systematic review and meta-analysis. Eur. J. Med. Res. 27, 1–13.
Seaquist, E.R., Anderson, J., Childs, B., Cryer, P., Dagogo-Jack, S., Fish, L., Heller, S.R., Rodriguez, H., Rosenzweig, J., Vigersky, R., 2013. Hypoglycemia and diabetes: A report of aworkgroup of the American diabetes association and the endocrine society. Diabetes Care 36, 1384–1395.
Silbert, R., Salcido-Montenegro, A., Rodriguez-Gutierrez, R., Katabi, A., McCoy, R.G., 2017. Hypoglycemia among Patients with Type 2 Diabetes: Epidemiology, Risk Factors, and Prevention Strategies. Physiol. Behav. 176, 100–106.
Sircar, M., Bhatia, A., Munshi, M., 2016. Review of Hypoglycemia in the Older Adult: Clinical Implications and Management. Can. J. Diabetes 40, 66–72.
Siti Setiati, n.d. BUKU AJAR ILMU PENYAKIT DALAM EDISI KEENAM JILID I, 6th ed. InternaPublishing, Jakarta.
Soelistijo, S., 2021. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2021. Glob. Initiat. Asthma 46.
Su, Y.-J., Lai, Y.-C., Liao, C.-J., 2017. Hazardous factors besides infection in hypoglycemia. Biomed. Reports 6, 480–484.
Tsai, S.H., Lin, Y.Y., Hsu, C.W., Cheng, C.S., Chu, D.M., 2011. Hypoglycemia revisited in the acute care setting. Yonsei Med. J. 52, 898–908.
Zheng, Z., He, D., Chen, J., Xie, X., Lu, Y., Wu, B., Jiang, X., 2023. Risk of Urinary Tract Infection in Patients with Type 2 Diabetes Mellitus Treated with Dapagliflozin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clin. Drug Investig. 43, 209–225.
Unduhan
Diterbitkan
Lisensi
Hak Cipta (c) 2024 Jansen Irawan, Irawan Melissa, Wibowo Dharma Mulya E
Artikel ini berlisensi Creative Commons Attribution 4.0 International License.
