Type 2 diabetes mellitus hypoglycemia

Miller CD, Phillips LS, Ziemer DC, Gallina DL, Cook CB, El-Kebbi IM. Hypoglycemia in patients with type 2 diabetes mellitus. Arch Intern Med 2001 161(13) 1653-9. 

Burge MR, Schmitz-Fiorentino K, Fischette C, Qualls CR, Schade DS. A prospective trial of risk factors for sulfonylurea-induced hypoglycemia in type 2 diabetes mellitus. JAMA I998 279(2) l 37 13. 

Ovalle F, Fanelli CG, Paramore DS, Hershey T, Craft S, Cryer PE. Brief twice-weekly episodes of hypoglycemia reduce detection of clinical hypoglycemia in type 1 diabetes mellitus. Diabetes 1998 47(9) 1472-9. 

Jeha GS, Karaviti LP, Anderson B, O Brian Smith E, Donaldson S, McGirk TS, Haymond MW. Insulin pump therapy in preschool children with type 1 diabetes mellitus improves glycemic control and decreases glucose excursions and the risk of hypoglycemia. Diabetes Technol Ther 2005 7 876-84. 

Severe hypoglycemia occurred in two elderly men with type 2 diabetes mellitus and mild to moderate impaired renal function, who took clarithromycin 1000 mg/day for respiratory infections, in addition to a sulfonylurea (glibenclamide 5 mg/day in one case and glipizide 15 mg/day in the other) (168). Both developed severe hypoglycemia within 48 hours of starting clarithromycin. 

Ibuprofen (150 mg, 3 doses) for arthralgias was associated with hypoglycemia in a 72-year-old man who was taking glibenclamide 2.5 mg/day for type 2 diabetes mellitus ... 

Like other diuretics etacrynic acid can impair glucose tolerance in patients with type 2 diabetes mellitus (384). Non-ketotic hyperglycemia has also been reported (385). However, hypoglycemia has also been reported in two patients with uremia (386). 

Hypoglycemia has uncommonly been reported with levofloxacin and appears to occur most often in elderly patients with type 2 diabetes mellitus who are taking oral hypoglycemics. A new case has been reported (597). 

Bober E, Buyukgebiz A, Verrotti A, Chiarelli F. Hypoglycemia, hypoglycemia unawareness and counterregulation in children and adolescents with type 1 diabetes mellitus. J Pediatr Endocrinol Metab. 2005 18 831-841. 

Hypoglycemia has also been reported in a 70-year-old woman with type 2 diabetes mellitus taking disopyramide (14). 

Glucagon, which is produced in the alpha cells of the islets of Langerhans, is used in diabetes mellitus type 1 to stimulate glucose output from the liver during hypoglycemia (1 mg subcutaneously, repeated once or twice) when glucose cannot be given intravenously. In some countries... 

Prinzmetal s vasospastic angina, bronchospastic chronic obstructive pulmonary disease (COPD), asthma, occlusive peripheral vascular disease, type I diabetes mellitus that is prone to hypoglycemia, heart block, and excessive bradycardia are contraindications to /3-blockers. The main side effects of /S-blockers are... 

Fanelli CG, Pampanelli S, Porcellati F, et al. Administration of neutral protamine Flagedorn insulin at bedtime versus with dinner in type 1 diabetes mellitus to avoid nocturnal hypoglycemia and improve control. A randomized, controlled trial. Ann Intern Med 2002 136 504-514. 

Metabolism Prickly pear cactus is a popular food among Mexicans, Mexican-Ameri-cans, and Hispanics and is commonly used to treat type 2 diabetes mellitus. The combination of prickly pear cactus with oral hypoglycemic agents, such as metformin and glipizide, in patients with type 2 diabetes mellitus may increase the risk of hypoglycemia because of additive blood glucose lowering effects [70" ]. 

Regardless of the type of diabetes, two major complications can occur—excess glucose owing to ineffective insulin function and decreased glucose if insulin is provided in excess amounts. The symptoms of diabetes mellitus (hyperglycemia) and a complication of excessive treatment (hypoglycemia) are shown in Table 12-4. 

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