Question of the Day – Monday March 23, 2020

In patient with a healthy pancreas and sulfonylurea overdose, administration of dextrose may result in an increase in hypoglycemic episodes. What treatment option should be utilized to promote stabilization of serum glucose levels?

Octreotide should be initiated at 25-100 mcg q6h PRN to achieve euglycemia. Treatment reduced the number of hypoglycemic episodes from 3.3 pre-octreotide to 0.4 post-octreotide. It works as a somatostatin analogue that binds receptor on the pancreatic beta cells, blocking the influx of calcium into the cell that is required for insulin release. (Dougherty PP, Klein‐Schwartz W. Octreotide’s role in the management of sulfonylurea‐induced hypoglycemia. J Med Toxicol 2010; 6: 199–206. DOI: 10.1007/s13181-010-0064-z)

Submitted by Ryan Feldman, PharmD on behalf of the Acute and Intensive Care Section