Oral Hypoglycemic Agent Toxicity Clinical Presentation

Updated: Jan 15, 2020
  • Author: David Tran, MD; Chief Editor: Stephen L Thornton, MD  more...
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Presentation

History

A single tablet of sulfonylurea (eg, a glipizide 5-mg tablet) may produce hypoglycemia in a child. Glipizide has been reported to produce hypoglycemia within 5 minutes of ingestion in an adult.  Patients usually become symptomatic within 2 hours of ingestion. Symptoms of hypoglycemia may be delayed if food is taken with the oral hypoglycemic agents. Symptoms may include the following:

  • Lethargy

  • Confusion

  • Irritability

  • Unresponsiveness

  • Dizziness

  • Headache

  • Blurred vision

  • Psychotic behavior

  • Emesis

  • Delirium

  • Feeding difficulties

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Physical Examination

Patient presentation depends on the severity and duration of hypoglycemia. In the nondiabetic individual, signs and symptoms of hypoglycemia may not occur until serum glucose drops below 40 mg/dL. Signs may include the following:

  • Altered mental status

  • Generalized weakness

  • Diaphoresis

  • Tachycardia

  • Tachypnea

  • Transient neurologic deficit

  • Pallor

  • Seizure

  • Cyanosis

  • Coma

  • Hypothermia

  • Athetotic movement

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