Medically induced hypoglycemia: focus on medications not included in the group of antihyperglycemic medications

Recently, doctors face the problem of patients with hypoglycemia conditions caused by the use of drugs that are not drugs for the treatment of diabetes. This is due to the increase in the number of multimorbid diseases in people of older age groups and, consequently, an increase in the number of drugs used simultaneously (polypharmacy). Hypoglycemia can complicate the course of concomitant diseases, contributes to the occurrence of arrhythmias, increases the risk of cardiovascular events, cognitive impairment, including dementia, increases the frequency and duration of episodes of myocardial ischemia. Risk factors for the development of drug-induced hypoglycemia include: elderly and senile age; reduced glomerular filtration rate, liver failure (reduced gluconeogenesis), reduced food consumption (insufficient glucose consumption); excessive alcohol consumption (reduced gluconeogenesis, insufficient food intake); simultaneous intake of several drugs that can lead to hypoglycemia. The most frequently drug-induced hypoglycemia develops against the background of the use of quinolones, pentamidine, quinine, β-blockers, angiotensin-converting enzyme inhibitors and insulin-like growth factor. The main vehicle to prevent drug-induced hypoglycemia is to stop its use and/or replace it with another drug that does not have this side effect. If it is impossible to completely abandon the drug, it is necessary to minimize the risk of hypoglycemia in the following ways: use long-term administration of the same concentration of the drug (if possible, prolonged forms), reduce the dose of the drug (use the lowest possible effective doses), control the concentration of glucose in the blood.

hypoglycemia, drug-induced hypoglycemia, adverse drug reaction, older age