Hypoglykemie bij orale bloedglucoseverlagende middelen: Kans op recidief na herstel van de glucosespiegel

Three patients, two women aged 83 and 79 years, and one man aged 61 years, known with diabetes mellitus and using oral blood glucose-lowering drugs, presented with impaired consciousness due to hypoglycaemia. Two of them were admitted and recovered well after recurrence of hypoglycaemia in one and discontinuation of medication in both. The third patient had prolonged hypoglycaemia and died three weeks later, still unconscious, due to pneumonia. Older patients with hypoglycaemia caused by longer acting sulphonylurea derivatives should be admitted, especially if they live alone or have risk factors such as renal or hepatic insufficiency. Intravenous glucose should be given if necessary. Discontinuation of the longer acting sulphonylurea derivative or replacement with a shorter acting drug should be considered.