Abstract #1404669: Diazoxide in the Treatment of Asymptomatic Refractory Hypoglycemia in End Stage Renal Disease

Diabetic patients with end-stage renal disease (ESRD) treated insulin or any other diabetic agent show high variations in their glucose metabolism, lower clearance level, and uncertain accuracy of glycemic control measurements. Therefore, these are at a greater risk developing hypoglycemia. Diazoxide use the treatment spontaneous refractory hypoglycemia this population has not been well documented. We report case young male that successfully diazoxide for his asymptomatic hypoglycemic episodes. A man type 2 diabetes mellitus complicated by nephropathy, on hemodialysis ESRD, presented shortness breath due to COVID pneumonia. After resolution infection, he was noted have recurrent episodes, although off medications past few years worsening kidney function. His oral intake adequate there no concern malnutrition, substance use. From testing performed, we were able exclude exogenous secretagogues presence antibodies. Insulin noninsulin (insulin-like growth factor) mediated mechanisms also ruled out. Since having episodes minimize need supplemental dextrose containing fluids, started 3 mg/kg/day. Knowing fluid retention diazoxide, patient tolerated it well. helped reduce then safely discharged it. In can be explained impaired contribution kidneys gluconeogenesis release, as higher levels caused resistance decrease clearance. When persisted even after further work-up done causes Generally, is used manage symptoms congenital hyperinsulinism, insulinomas post bariatric surgery cases hyperinsulinemic However, optimal when comes treating ESRD because its side effects; specifically, retention, electrolyte imbalances. our case, last resort, despite known effects limited documentation patients. Actually, reports, shown promising results purpose minimal effects. enough studies benefits risks long-term patients, an area growing interest.