Here we present a case of refractory hypoglycaemia associated with use of the antibiotic trimethoprim-sulfamethoxazole (TMP-SMX). This was used to treat Pneumocystis jirovecii pneumonia (PCP) infection. The patient had significant pre-existing renal impairment with a kidney transplant in situ. Refractory hypoglycaemia occurred 5 days after starting the antibiotic and persisted for 36 h after its cessation. SMX contains the same sulphanilamide structural group as the oral hypoglycaemic agents called sulphonureas. SMX could therefore act as an insulin secretagogue. The inappropriately raised insulin and c-peptide levels seen in our patient support this theory. The 5-day asymptomatic period would allow sufficient time for the drug to accumulate and the extended period seen after its cessation would be seen in a dose-dependent side effect. Following 3 days of observation and continuous glycaemic support on the High Dependency Unit she was discharged back to the ward, with no further occurrence of hypoglycaemia.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4544489 | PMC |
| http://dx.doi.org/10.1136/bcr-2012-007215 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association Between Daily Insulin Dose Adjustments and Glycemic Control in Non-Critically Ill Hospitalized Hyperglycemic Patients: A Retrospective Cohort Study.
Endocr Pract
January 2025
Division of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address:
Objective: To evaluate the efficacy of daily insulin dose increases in managing inpatient hyperglycemia.
Methods: Retrospective study of patients discharged from two urban academic medical centers and three large suburban community hospitals between 2015 and 2019 who received ≥10 units of basal insulin on any day. On hyperglycemic days (mean glucose ≥180 mg/dL), we categorized the relative insulin dose increases into four categories based on percentage changes from the previous day.
European Survey on Adults with Type 1 Diabetes and their Caregivers: Insights into Personal Experience and Needs for Improving Diabetes Care.
Diabetes Ther
January 2025
Diabetes-Zentrum Mergentheim, Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Universität Bamberg, Bamberg, Germany.
Introduction: Type 1 diabetes (T1D) requires constant self-management and substantially impacts daily life. We surveyed the experiences/burdens of people with T1D (PWD) and their caregivers.
Methods: An online survey of PWD/caregivers (aged ≥ 18 years) living in five European countries was conducted from July to August 2021.
Re-evaluating large for gestational age: differential effects on perinatal outcomes in term and premature births.
Front Med (Lausanne)
January 2025
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Objective: Pregnancies with large-for-gestational-age (LGA) fetuses are associated with increased risks of various adverse perinatal outcomes. While existing research primarily focuses on term neonates, less is known about preterm neonates. This study aims to explore the risks of adverse maternal and neonatal perinatal outcomes associated with LGA in term neonates and neonates with different degrees of prematurity, compared to appropriate-for-gestational-age (AGA) neonates.
View Article and Find Full Text PDFInsulinoma in Patients with Diabetes- A Systematic Review of Previously Reported Cases.
Indian J Endocrinol Metab
September 2024
Department of Endocrinology and Metabolism, Medical College and Hospital, Kolkata, West Bengal, India.
Introduction: Paradoxical co-existence of insulinoma and diabetes is extremely rare. Although a few case reports addressed this association, a comprehensive study elucidating this relationship has been lacking. We performed a systematic review of published cases of insulinoma in diabetes.
View Article and Find Full Text PDFShorter Digestion Times of Donor Islets Is Associated With Better Islet Graft Function After Islet Transplantation.
Cell Transplant
January 2025
Department of Translational Research & Cellular Therapeutics, Arthur Riggs Diabetes & Metabolism Research Institute, City of Hope, Duarte, CA, USA.
Although islet transplantation is effective in reducing severe hypoglycemia events and controlling blood glucose in patients with type 1 diabetes, maintaining islet graft function long-term is a significant challenge. Islets from multiple donors are often needed to achieve insulin independence, and even then, islet function can decline over time when metabolic demand exceeds islet mass/insulin secretory capacity. We previously developed a method that calculated the islet graft function index (GFI) and a patient's predicted insulin requirement (PIR) using mathematical nonlinear regression.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!