Twenty-Seven Patients with Hypoglycemic Coma Requiring Hospitalization during Oral Hypoglycemic Treatment

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  • Nagayama Koji
    Department of Diabetes and Endocrinology, Hamamatsu Medical Center
  • Kakizawa Keisuke
    Department of Diabetes and Endocrinology, Hamamatsu Medical Center
  • Okawa Yuta
    Department of Diabetes and Endocrinology, Hamamatsu Medical Center
  • Morita Hiroshi
    Second Department of Internal Medicine, Hamamatsu University School of Medicine
  • Oki Yutaka
    Second Department of Internal Medicine, Hamamatsu University School of Medicine
  • Nakamura Hirotoshi
    Second Department of Internal Medicine, Hamamatsu University School of Medicine

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Other Title
  • 経口血糖降下薬による低血糖性昏睡で入院加療を要した27症例の検討
  • [日本糖尿病学会]中部地方会推薦 経口血糖降下薬による低血糖性昏睡で入院加療を要した27症例の検討
  • ニホン トウニョウビョウ ガッカイ チュウブ チホウカイ スイセン ケイコウ ケットウ コウカヤク ニ ヨル テイケットウセイ コンスイ デ ニュウイン カリョウ オ ヨウシタ 27 ショウレイ ノ ケントウ

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We reviewed 27 patients in a hypoglycemic coma who required hospitalization during oral hypoglycemic treatment between April 2007 and March 2010. Patients were aged 79.4±9.4 years and their HbA1c level was low (6.1±0.8%, JDS). Almost all patients received sulfonylurea (26/27). The agens that were most prescribed were glimepiride (18), followed by glibenclamide (8) and other drugs (2). Five patients were treated by diabetes specialists, and the other 22 by primary care physicians. Nineteen patients (71%) experienced poor dietary intake, vomiting, and diarrhea during hypoglycemic events. When we prescribe sulfonylurea in aged patients, we should be careful to avoid hypoglycemic events, and we educate attending nurses and physicians on how to cope with these comatose patients on those occasions when the patients are physically sick and vomitin. Since many diabetic patients are treated by primary care physicians, education about diabetes care is also required for these physicians.<br>

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