Prolonged Hypoglycemia Secondary to Tolbutamide
Authors: EDWARD D. BIRD
Journal: Annals of Internal Medicine (1965)

Case Studies1 January 1965Prolonged Hypoglycemia Secondary to TolbutamideEDWARD D. BIRD, M.B., B.S., FRANK C. SCHWALBE JR., M.D.EDWARD D. BIRD, M.B., B.S.Search for more papers by this author, FRANK C. SCHWALBE JR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-1-110 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe development of prolonged hypoglycemia after use of tolbutamide is rare, having been reported in only a few elderly subjects and in patients with renal insufficiency (1-5). The purpose of this report is to describe the occurrence of hypoglycemic coma in a young patient after a small dose of tolbutamide. Data are presented that demonstrate that the patient was unable to metabolize tolbutamide normally.CASE HISTORYA 15-year-old girl was brought to the emergency room in a comatose state. One month previously, the patient had noted episodes of weakness, fatigue, and dizziness that were not related to food intake. One...References1. YONETBALLARD HMHS: Prolonged severe hypoglycemia following tolbutamide therapy for paralysis agitans. New York J. Med. 61: 1939, 1961. MedlineGoogle Scholar2. SCHWARTZ JF: Tolbutamide—induced hypoglycemia in Parkinson's disease. Case report. JAMA 176: 106, 1961. CrossrefMedlineGoogle Scholar3. KREEGER N: Tolbutamide—induced hypoglycemia. New Eng. J. Med. 266: 818, 1962. CrossrefMedlineGoogle Scholar4. BOLINGERTUCKENDALL REWHC: Oral hypoglycemic agents—clinical experience with 50 diabetic subjects. J. Kansas Med. Soc. 61: 135, 1960. MedlineGoogle Scholar5. CUSHMANDUBOISDWYERIZZO PJJEJL: Protracted tolbutamide hypoglycemia. Amer. J. Med. 35: 196, 1963. CrossrefMedlineGoogle Scholar6. FAJANSCONN SSJW: Intravenous tolbutamide test as adjunct in diagnosis of functioning pancreatic islet cell adenoma. J. Lab. Clin. Med. 54: 811, 1959. Google Scholar7. FLANAGANSCHWARTZRYAN GCTBWG: Studies on patients with islet-cell tumor, including the phenomenon of leucine-induced accentuation of hypoglycemia. J. Clin. Endocr. 21: 401, 1961. CrossrefGoogle Scholar8. STOWERSMAHLERHUNTER JMRFRB: Pharmacology and mode of action of the sulphonylureas in man. Lancet 1: 278, 1958. CrossrefMedlineGoogle Scholar9. FAJANSLOUISSELTZERJOHNSONGITTLERHENNESWAJCHENBERGACKERMANCONN SSLHHSRDRDARBLIPJW: Sulphonylurea symposium: metabolic effects of arylsulphonylurea compounds in normal men and in diabetic subjects. Metabolism 5: 820, 1956. MedlineGoogle Scholar10. JOHNSONHENNESDRISCOLLWEST PCARTKM: Metabolic fate of chlorpropamide in man. Ann. NY Acad. Sci. 74: 459, 1958-59. CrossrefGoogle Scholar11. BAIRDRICKARDS IMDF: Hypoglycemic coma during change from insulin to tolbutamide. Brit. Med. J. 2: 1585, 1962. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Gainesville, FloridaFrom the Department of Medicine, College of Medicine, University of Florida, Gainesville, Fla.These studies were supported in part by grant 2A-5172, National Institutes of Health, U. S. Public Health Service, Bethesda, Md.Dr. Schwalbe is a Postdoctoral Fellow, National Institute of Arthritis and Metabolic Diseases, National Institutes of Health, Bethesda, Md.Requests for reprints should be addressed to Edward D. Bird, College of Medicine, University of Florida, Gainesville, Fla. 32603. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byImplications of pharmacogenetics for individualizing drug treatment and for study designCYP2C9 polymorphism: impact on tolbutamide pharmacokinetics and responseDrug-Induced Hypoglycemia: A Review of 1418 CasesIntramuscular or intravenous glucagon for sulphonylurea hypoglycaemia?Effect of phenyramidol and bishydroxycoumarin on the metabolism of tolbutamide in human subjectsPotentiation of Acetohexamide Hypoglycemia by PhenylbutazoneNEED FOR GLUCAGON IN SEVERE HYPOGLYCÆMIA INDUCED BY SULPHONYLUREA DRUGSNine years' experience with tolbutamide in the treatment of diabetes 1 January 1965Volume 62, Issue 1Page: 110-112KeywordsAttentionComaElderlyEmergency departmentFatigueHypoglycemiaHypoglycemicsMedical servicesMetabolic disordersPrevention, policy, and public health Issue Published: 1 January 1965 PDF downloadLoading ...