Recurrent and persistent hypoglycemia following intoxication with glibenclamide overdose: case report

Background: Hypoglycemia can cause permanent damage to the brain or lead to death. That is why it is very important to prevent or quickly correct hypoglycemia to save life for the treatment of hypoglycemia following the use of Sulfonylureas, taking oral nutrition for the patient or administration of injectable hypertonic glucose is recommanded. But recurrence and resistance to treatment are common in sulfonylurea poisoning. Due to the vulnerability of the brain to long-term hypoglycemia, plasma glucose concentrations should be returned to normal as soon as possible and recurrences of hypoglycemic attacks should be prevented. Because Octreotide is of particular importance in the control of hypoglycemia, this study aimed to use Octreotide to treat recurrent and refractory hypoglycemia due to Glibenclamide use. Case presentation: In this study, four patients with an average age of 30.75 years and an age range of 18-40 years were evaluated and managed. Following suicide with a high dose of Glibenclamide, they had refractory hypoglycemic attacks So for these patients, Octreotide was started at a dose of 50 μg every 6 hours, and all of them responded to Octreotide therapy, and the hypoglycemic attacks were greatly reduced. All patients were treated with Dextrose 50% at the time of admission. However, their blood glucose dropped significantly and did not respond to the dextrose diet. However, receiving the first dose of Octreotide with a significant increase in patients' blood glucose showed a favorable effect of Octreotide in this study. Conclusion: In hypoglycemia caused by Sulfonylureas, Octreotide is used temporarily. Octreotide is a somatostatin analogue that inhibits insulin secretion. In this study, it was found that in cases of recurrent hypoglycemia and resistance to common therapies, the use of Octreotide at a dose of 50 μg every 6 hours is desirable and the patient can be discharged with appropriate blood sugar So that the use of Octreotide played an important role in controlling recurrent and refractory hypoglycemia in patients with glibenclamide poisoning