J Med Life Sci > Volume 14(2); 2017 > Article
Journal of Medicine and Life Science 2017;14(2):74-76.
DOI: https://doi.org/10.22730/jmls.2017.14.2.74    Published online December 18, 2018.
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Metronidazole Induced Hypoglycemia on an Elderly Patient without Diabetes
Jun Hyun Park, Sang Ah Lee
Correspondence:  Sang Ah Lee,
Abstract
In the elderly, diabetes patients often experienced hypoglycemia due to medication. However, hypoglycemia can occur in a wide variety of situations without diabetes such as these cases including heavy alcohol drinking, decreased liver function, sepsis, pneumonia, and decreased renal function, etc. In this case, hypoglycemia occurred in treating with cefotaxime and metronidazole in patients with abdominal pain due to intravascular embolism at the entrance of the superior mesenteric artery. This hypoglycemia was accompanied by hyperinsulinemia. The possibility of other adrenal insufficiency was excluded because of normal response in rapid ACTH test. Insulinoma was also excluded because of no experience of hypoglycemia before admission and no tumor in pancreas in CT scan. In addition, renal function was recovering, so renal function was unlikely to be a cause.We doubt the possibility of antimicrobial agents,cefotaxime and metronidazole, as a cause of hypoglycemia. Firstly, we stopped cefotaxime, but continued hypoglycemia until day 3. And, as the next step, we quit the use of metronidazole and then hypoglycemia was recovered. In this case, we suggested that hypoglycemia was related with metronidazole. Hypoglycemia associated with metronidazole is mainly associated with the use of diabetes medications in previous cases, and few cases of hypoglycemia in patients without such diabetes have been reported. Therefore, we report hypoglycemia associated with the use of metronidazole in elderly patients without diabetes.
Key Words: Elderly, Hyperinsulinemic, Hypoglycemia, Metronidazole
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