Medication
- Quinolones (32 publications, 826 patients). ...
- Pentamidine (29 publications, 330 patients; OR, 41.9; 95% CI, 7.7, 227.7; moderate quality evidence).
- Quinine (30 publications, 326 patients; OR, 1.71; 95% CI, 0.72, 4.02; moderate quality evidence).
- Beta blockers (49 publications, 131 patients; OR, 1.9; 95% CI, 0.4, 9.4; very low quality evidence).
Therapy
Drugs that Cause Hypoglycemia. insulins. sulfonylureas: glipizide, glyburide, glimiperide, chlorpropamide, acetohexamide, tolbutamide. meglitinides: repaglinide, nateglinide. pramlintide plus insulin.
Self-care
Treatment
- Hypoglycemic management. Eat or drink something that's mostly sugar or carbohydrates to raise your blood sugar level quickly.
- Emergency treatment. Glucagon is a hormone that raises blood sugar quickly. ...
- Difficult-to-manage hypoglycemia. ...
- Hypoglycemia unawareness. ...
Nutrition
Some people have a greater risk of diabetic hypoglycemia, including:
- People using insulin
- People taking certain oral diabetes drugs (sulfonylureas)
- Young children and older adults
- Those with impaired liver or kidney function
- People who've had diabetes for a longer time
- People who don't feel low blood sugar symptoms (hypoglycemia unawareness)
- Those taking multiple medications
Specialist To Consult
What medications can cause hypoglycemia?
Which diabetes drugs cause hypoglycemia?
What is an appropriate treatment for hypoglycemia?
What medications cause low blood sugar?
What drugs cause hypoglycemia unawareness?
Non-selective beta-blockers used to manage high blood pressure, like Inderal (see here for a complete list), may reduce your ability to recognize hypoglycemia. Selective serotonin reuptake inhibitors (SSRIs) used to treat depression may also have this effect. Common SSRIs include Lexapro, Prozac, and Zoloft.
What medications affect hypoglycemia?
For example, theophylline and corticosteroids (like intravenous hydrocortisone) may cause hypokalemia at extremely high doses, but they aren't discussed below.Diuretics. ... Short- and long-acting beta agonists. ... Laxatives. ... Aminoglycosides. ... Amphotericin B. ... Insulin. ... Angiotensin-converting enzyme inhibitors.More items...•
What is the drug used to counteract severe hypoglycemic reactions?
Glucagon is used along with emergency medical treatment to treat very low blood sugar. Glucagon is also used in diagnostic testing of the stomach and other digestive organs. Glucagon is in a class of medications called glycogenolytic agents. It works by causing the liver to release stored sugar to the blood.
Does carvedilol mask hypoglycemia?
In fact, BBs including the nonselective agent carvedilol, have been shown to prevent the expected impaired autonomic response to hypoglycemia known to follow an antecedent hypoglycemic event [13, 14].
Can beta-blockers cause hypokalemia?
Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells, leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.
Can low potassium cause high blood sugar?
If your potassium levels are too low, your body may make less insulin. That could lead to high blood sugar. Studies show that people with low potassium levels release less insulin, have higher blood sugar levels, and are more likely to get type 2 diabetes than those with normal potassium levels.
What helps hypoglycemia immediately?
If you have hypoglycemia symptoms, do the following: Eat or drink 15 to 20 grams of fast-acting carbohydrates. These are sugary foods or drinks without protein or fat that are easily converted to sugar in the body. Try glucose tablets or gel, fruit juice, regular (not diet) soda, honey, or sugary candy.
What is the immediate treatment for hypoglycemia?
The immediate treatment for hypoglycaemia is to have some food or drink that contains sugar, such as dextrose tablets or fruit juice, to correct your blood glucose levels. After having something sugary, you may need to have a longer-acting "starchy" carbohydrate food, such as a sandwich or a few biscuits.
How do you treat unconscious hypoglycemia?
If the person is unconscious, having seizures, or too disoriented to swallowLocate a glucagon emergency kit or glucagon nasal powder, if it's available. ... Administer the glucagon emergency kit or glucagon nasal powder. ... Turn the person on their side. ... Call 911 or your local number for emergency medical services.More items...•
Do all beta blockers mask hypoglycemia?
Official answer. Beta-blockers can mask the symptoms of hypoglycemia, such as a rapid heartbeat and tremor because they block the effects of norepinephrine, which results in a slowing of your heart rate and a reduced tremor. Hunger, irritability, and confusion may be concealed as well.
Do beta blockers cause hypoglycemia?
β-blockers can cause or exacerbate hypoglycemia in some individuals, either by worsening an already present hypoglycemic episode or by delaying recovery time.
Do beta blockers cause hypoglycemia unawareness?
Although beta-blocker may theoretically attenuate hypoglycemic symptoms or lead to worsening of hypoglycemia, multiple studies have proven that beta-blockers increase hypoglycemic symptoms and can be safely used in insulin-dependent diabetes patients.
What medications affect blood sugar?
Antidepressants (Zyprexa, risperdal, Clozaril, Seroquel, Abilify, Geodon, lithium) Beta-2 stimulators (Proventil, Alupent, Serevent, Foradil, Brethine, Theo-Dur) Caffeine. Corticosteroids (Prednisone, Decadron, DepoMedrol)
Which of the following classes of medications carries a high risk of hypoglycemia?
Patients on sulfonylureas and meglitinides have the highest incidence of hypoglycemia because of their pharmacological action of increasing insulin secretion. Of the sulfonylureas, glyburide presents the highest risk of hypoglycemia.
What is the most common cause of low blood sugar?
Low blood sugar is most common among people who take insulin, but it can also occur if you're taking certain oral diabetes medications. Common causes of diabetic hypoglycemia include: Taking too much insulin or diabetes medication. Not eating enough.
How do beta blockers affect hypoglycemia?
β-blockers can cause or exacerbate hypoglycemia in some individuals, either by worsening an already present hypoglycemic episode or by delaying recovery time.
Drugs used to treat Hypoglycemia
The following list of medications are in some way related to, or used in the treatment of this condition.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
What type of diabetes is FDA approved for?
FDA-approved indicationsfor the use of oral hypoglycemic drugs primarily focus on type 2 diabetes mellitus.
How does meglitinide affect insulin secretion?
Meglitinidesexert their effects via different pancreatic beta-cell receptors, but they act similarly to sulfonylureas by regulating adenosine triphosphate-sensitive potassium channels in pancreatic beta cells, thereby causing an increase in insulin secretion.
How much linagliptin is given daily?
Among the DPP- 4 inhibitors, linagliptin is available as 5 mg daily. Vildagliptin is given as 50 mg once or twice weekly, Sitagliptin as 25 mg, 50 mg, or 100 mg once daily, and Saxagliptin as 2.5 mg or 5 mg once daily.
What is the best way to manage diabetes mellitus?
The most effective management of diabetes mellitus demands an interprofessional approach involving both lifestyle modifications with diet and exercise and pharmacologic therapies as needed to meet individualized glycemic goals. Healthcare practitioners must encourage patients to combine lifestyle modifications with oral pharmacologic agents for optimal glycemic control, particularly as type 2 diabetes mellitus progresses with continued loss of pancreatic beta-cell function and insulin production. [1][2][3][4][5]
What is the role of sulfonylureas in the pancreas?
Sulfonylureasbind to adenosine triphosphate-sensitive potassium channels (K-ATP channels) in the beta cells of the pancreas; this leads to the inhibition of those channels and alters the resting membrane potential of the cell, causing an influx of calcium and the stimulation of insulin secretion.
How many tablets of repaglinideis are there?
Repaglinideis available as 0.5 mg, 1 mg, or 2 mg tablets, taken orally in two to three divided doses per day.
What is the function of thiazolidinediones?
Thiazolidinediones activate peroxisome proliferator-activated receptor gamma (PPAR-γ), a nuclear receptor, which increases insulin sensitivity and resultant peripheral uptake of glucose and increases the level of adiponectin, a fat tissue-secreted cytokine, that increases not only the number of insulin-sensitive adipocytes but also stimulates fatty acid oxidation.
What drugs affect glucose levels?
What drugs affect glucose levels? Many can, including steroids, anxiety and depression medications, statins, beta-blockers, some acne & asthma medications .
What is Pioglitazone?
Pioglitazone (Actos®) – ( hypoglycemia usually only when in combination with other diabetic drugs such as sulfonylureas or insulin)
Is ephedrine a guaifenesin?
Ephedrine and Guaifenesin ( Primatene ® tablets, otc – this medication includes ephedrine and guaifenesin. Guaifenesin is not responsible for hyperglycemia )
Does caffeine raise blood sugar?
Caffeine (Caffeine in moderation may be beneficial in diabetes, but in large amounts can raise blood sugar.)
Does glucosamine increase insulin resistance?
Glucosamine (Possible increase in insulin resistance; more likely with intravenous use)
How many medications are associated with hypoglycemia?
We conducted a systematic review of the literature and compiled a list of 164 different medications associated with hypoglycemia. Most exposures were consistent with appropriate dosing rather than an overdose and hypoglycemia episodes were usually symptomatic and severe. Reported cases usually describe patients who were elderly, had renal or hepatic insufficiency, were on insulin or sulfonylureas, or had severe systemic disease.
What is the purpose of drug induced hypoglycemia?
Objective: The aim of the study was to systematically review the literature for drugs reported to cause hypoglycemia and assess the quality of evidence and strength of association supporting this causal link.
What databases were used to search for hypoglycemia?
To identify eligible studies, we searched electronic databases (MEDLINE, EMBASE, Web of Science, and SCOPUS) through November 2007. In addition, the drug information system Micromedex was searched for hypoglycemic reactions in nondiabetic medications. The search strategy, which was tailored to each database, included controlled vocabulary and text words describing the concept of hypoglycemia and the subheadings: chemically-induced, epidemiology, and etiology, which were exploded in MEDLINE. In EMBASE, we used the term hypoglycemia with the subheadings side effect, epidemiology, and etiology, as well as the term “drug-induced disease.” Both searches also included the terms blood glucose/drug effects. Specific drug families/adverse effects (excluding hypoglycemic agents) were AND-ed to the concept of hypoglycemia. Text words were used in SCOPUS and Web of Science: “drug-induced” SAME (hypoglycaem* or glycem* or glycaem* or hypoglycemi*) or (hypoglycaem* or glycem* or glycaem* or hypoglycemi*) SAME (effect or effects or induced or caused) AND drug.*
What is the hypoglycemia task force?
The Hypoglycemia Task Force of The Endocrine Society pursued the endeavor of developing clinical practice guidelines for preventing and treating hypoglycemia. The Task Force commissioned this review with the aim of systematically reviewing the literature to compile a comprehensive list of medications that can cause hypoglycemia, to determine the extent to which clinical research evidence supports an association between the use of medications and hypoglycemia, and to estimate the magnitude of this association, when possible.
Why is the number of cases of hypoglycemia reported per drug not considered a factor that increased the quality?
Because a large number of published cases about a drug may only reflect the common usage of this drug, the number of cases of hypoglycemia reported per drug was not considered a factor that increased the quality of evidence or one that strengthened the association with hypoglycemia.
What are the nonspecific terms used in a case report of drug-induced hypoglycemia?
One of the challenges of this review was the identification of a case report of drug-induced hypoglycemia when hypoglycemia was not used as a keyword or when the report was indexed using generic, nonspecific terms such as, “blood glucose level,” “glucose metabolism,” “drug-induced disease,” or “side effects.” Only reading the full article in these instances can confirm whether it meets the inclusion criteria. Future studies should report and index hypoglycemia and all other adverse events clearly to reduce the effect of publication bias in systematic reviews reporting harm. The extension of the Consolidated Standards of Reporting Trials (CONSORT) statement has advocated improved reporting of harms to the extent of including these events in the abstract or even in the title of a manuscript when harms were significant ( 23 ).
Is hypoglycemia a side effect of a medication?
Eligible studies reported hypoglycemia as a side effect of a medication not used to treat hyperglycemia, regardless of their study design, language, size, or duration of patient follow-up.
Which type of diabetic is at greatest risk for hypoglycemia?
Individuals with long-standing insulin-dependent ( type 1) diabetes are at the greatest risk of hypoglycemia unawareness but type 2 diabetics who are taking insulin due to advanced disease are also at risk.
What is hypoglycemic unawareness?
Hypoglycemic Unawareness. Hypoglycemia or low blood sugar is a problem that arises in the management of diabetes. Diabetes mellitus usually describes a persistently high blood sugar.
Why is the brain desensitized to the symptoms of hypoglycaemia?
The brain may also be desensitized to the symptoms of hypoglycaemia as it becomes "used to" low blood sugar levels. With repeated hypoglycemia, the brain increases the number of glucose transporters in neurons to enable the brain to receive a constant supply of glucose, even when blood sugar levels are low.
Why does blood sugar drop?
However, various factors can cause blood sugar to plummet such as taking too much antidiabetic medication, engaging in vigorous exercise which can deplete the body of sugar, drinking too much alcohol or missing meals or snacks. However, the majority of diabetic patients experience symptoms that indicate when their blood sugar is becoming too low.
Can beta blockers cause hypoglycemia?
In addition, certain medications may mask the symptoms of hypoglycemia. For example, certain blood pressure medications such as beta blockers may blunt the effects of epinephrine so that the typical warning signs are not experienced.
What medications cause low blood sugar?
Medicines that can cause drug-induced low blood sugar include: Beta-blockers (such as atenolol, or propanolol overdose) Cibenzoline and quinidine (heart arrhythmia drugs) Indomethacin (a pain reliever) Insulin. Metformin when used with sulfonylureas.
What is SGLT2 inhibitor?
SGLT2 inhibitors (such as dapagliflozin and empagliflozin) with or without sul fonylureas. Sulfonylureas (such as glipizide, glimepiride, glyburide) Thiazolidinediones (such as pioglitazone and rosiglitazone) when used with sulfonylureas.
Why does blood sugar drop?
Causes. Expand Section. Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes. Other than certain medicines, the following can also cause blood sugar (glucose) level to drop: Drinking alcohol. Getting more activity than usual.
