Advertisement

Sustained hypoglycemia with therapeutic use of repaglinide

  • Philippe HantsonEmail author
  • Souleiman El Balkhi
  • Vincent Haufroid
  • Pierre-François Laterre
Case Report
  • 18 Downloads

Repaglinide is a short-acting insulin secretagogue used for the reduction in postprandial glucose levels in diabetic patients. It has a favorable safety profile with a low risk of hypoglycemia. Prolonged hypoglycemia appears exceptional due to the short serum elimination half-life.

A 67-year-old African man was admitted in the emergency department (ED) with altered consciousness and profound hypoglycemia (48 mg/dl). He had a long-lasting medical history of type 2 diabetes mellitus with retinopathy, peripheral arteriopathy, ischemic cardiomyopathy, arterial hypertension, atrial fibrillation and post-hepatitis C cryoglobulinemia with membranous proliferative glomerulonephritis. He was currently treated with numerous medications (Table  1). The only recent change was the self-administration of a daily dose of 1 mg colchicine over the last month to treat a gout attack. Repaglinide (1 mg b.i.d) had been introduced several months ago, as it was the case for clopidogrel. There was no insulin...

Notes

Authors’ contribution

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Philippe Hantson, Pierre-François Laterre, Vincent Haufroid and Souleiman El Balkhi. The first draft of the manuscript was written by Philippe Hantson, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

Human and animal rights disclosure

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

A written informed consent was obtained from the patient.

Sources of funding

None.

References

  1. 1.
    Marbury TC, Ruckle JL, Hatorp V, Nielsen KK, Huang WC, Strange P (2000) Pharmacokinetics of repaglinide in subjects with renal impairment. Clin Pharmacol Ther 67:7–15CrossRefGoogle Scholar
  2. 2.
    Bidstrup TB, Bjørnsdottir I, Sidelmann UG, Thomsen MS, Hansen KT (2003) CYP2C8 and CYP3A4 are the principal enzymes involved in the human biotransformation of the insulin secretagogue repaglinide. Br J Pharmacol 56:305–314CrossRefGoogle Scholar
  3. 3.
    Niemi M, Leathart JB, Neuvonen M, Backman JT, Daly AK, Neuvonen PJ (2003) Polymorphism in CYP2C8 is associated with reduced plasma concentrations of repaglinide. Clin Pharmacol Ther 74:380–387CrossRefGoogle Scholar
  4. 4.
    Tomalik-Scharte D, Fuhr U, Hellmich M et al (2011) Effect of the CYP2C8 genotype on the pharmacokinetics and pharmacodynamics of repaglinide. Drug Metab Dispos 39:927–932CrossRefGoogle Scholar
  5. 5.
    Wei Y, Lin FJ, Lin SY, Wang CC (2019) Risk of hypoglycemia and concomitant use of repaglinide and clopidogrel: a population-based nested case-control study. Clin Pharmacol Ther.  https://doi.org/10.1002/cpt.1556 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Intensive Care, Cliniques St-LucUniversité Catholique de LouvainBrusselsBelgium
  2. 2.Louvain Centre of Toxicology and Applied PharmacologyUniversité Catholique de LouvainBrusselsBelgium
  3. 3.Service de Pharmacologie, Toxicologie et PharmacovigilanceCHU de LimogesLimogesFrance

Personalised recommendations