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עמוד בית
Thu, 25.07.24

CASE COMMUNICATION

IMAJ | volume 25

Journal 5, May 2023
pages: 355-356

Old, But Not Outdated: Tolbutamide-Induced Refractory Hypoglycemia

1 Department of Internal Medicine B, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel 2 Department of Endocrinology and Metabolism, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel 3 Medical Corps, Israel Defense Forces, Ramat Gan, Israel

Summary

Sulfonylureas have been used to treat patients with diabetes for the last 80 years. The main side effect of this drug class is hypoglycemia, which might be severe and protracted. With the emergence of new medications with improved safety and better efficacy in preventing diabetes complications and cardiovascular morbidity and mortality, the use of these agents is waning.

Sulfonylureas are historically classified into two generations. The generation first includes drugs such as tolbutamide and chlorpropamide, which are no longer used. The second generation includes glibenclamide and glimepiride, which have different pharmacokinetic properties and active metabolites.

In this case report, we present a patient with diabetes and end-stage renal disease (ESRD) who developed prolonged hypoglycemia following the unauthorized use of a food supplement containing the first-generation sulfonylurea - tolbutamide.

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