Hypoglycemia insulin causing

Co-trimoxazole can cause reversible hypoglycemia, which may be prolonged, particularly in patients with risk factors for hypoglycemia. Common risk factors include compromised renal function, prolonged fasting, malnutrition, and the use of excessive doses. It has been postulated that the sulfonamide mimics the action of sul-fonylureas, stimulating pancreatic islet cells to secrete insulin. In elderly people, co-trimoxazole-induced hypoglycemia can cause altered mental state (1146,1147). 

Hypoglycemia is a primary complication of insulin therapy and may result from either an excess of insulin or a lack of glucose, or both. Severe hypoglycemia may cause headache, confusion, double vision, drowsiness, and convulsions. The treatment of this hypoglycemia may include the administration of glucose or glucagon. 

Metformin. Metformin [657-24-9] (1,1-dimethylbiguanide), mol wt 129.17, forms crystals from propanol, mp 218—220°C, and is soluble in water and 95% ethanol, but practically insoluble in ether and chloroform. Metformin, an investigational dmg in the United States, does not increase basal or meal-stimulated insulin secretion. It lowers blood glucose levels in hyperglycemic patients with Type II diabetes but has no effect on blood glucose levels in normal subjects. It does not cause hypoglycemia. Successful metformin therapy usually is associated with no or some weight loss. 

The notion that complex carbohydrates eHcit a gradual, steady secretion of insulin while sugars cause a sudden release of this hormone accompanied by a rapid drop in blood glucose has fostered the behef that hypoglycemia is affected by sucrose ingestion. However, research does not support this conclusion (63). 

The answer is d, (Hardman, pp 855-856.) Propranolol, as well as other non selective beta blockers, tends to slow the rate of recovery in a hypoglycemic attack caused by insulin. Beta blockers also mask the symptoms of hypoglycemia and may actually cause hypertension because of the increased plasma epinephrine in the presence of a vascular beta2 blockade. 

The answer is a. (Hardman, p 1510.) Although the mechanism of action of metformin and other biguanicies is unclear, biguanides virtually never cause hypoglycemia They operate independently of pancreatic p cells but are not useful in insulin-dependent diabetes mellitus (IDDM). Some possible mechanisms of action are direct stimulation of glycolysis in peripheral tissues, increased sensitivity to insulin, and reduction of glucagon levels. 

Hypoglycemia Pramlintide alone does not cause hypoglycemia. However, pramlintide is indicated to be coadministered with insulin therapy, and, in this setting, pramlintide increases the risk of insulin-induced severe hypoglycemia, particularly in patients with type 1 diabetes. Severe hypoglycemia associated with pramlintide occurs within the first 3 hours following a pramlintide injection. 

Hypoglycemia Hypoglycemia may result from excessive insulin dose or may be caused by Increased work or exercise without eating food not being absorbed in the usual manner because of postponement or omission of a meal or in illness with vomiting, fever, or diarrhea when insulin requirements decline. 

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