- 著者
- Kana Takayama Kohei Fujii Hiroki Yamaguchi Yumika Miyoshi Yuhei Uehara Shimpei Nagata Yoshinari Obata Motohiro Kosugi Yoji Hazama Tetsuyuki Yasuda
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.60, no.6, pp.905-910, 2021-03-15 (Released:2021-03-15)
- 参考文献数
- 22
- 被引用文献数
- 1 2
Hypoglycemia should be avoided when treating patients with diabetes. Repaglinide is an insulin secretagogue with a low hypoglycemic risk because of its rapid- and short-acting effects. However, its blood concentration has been reported to increase in combination with clopidogrel, an antiplatelet drug, and in patients with severe renal insufficiency. We herein report an elderly patient with type 2 diabetes mellitus and severe renal insufficiency who received repaglinide and hypoglycemia three days after starting clopidogrel. The concomitant use of repaglinide and clopidogrel can lead to hypoglycemia, especially in patients with severe renal insufficiency.
- 著者
- Shingo Fujita Junji Kozawa Chisaki Ishibashi Takekazu Kimura Tetsuhiro Kitamura Kenji Fukui Tetsuyuki Yasuda Hiromi Iwahashi Akihisa Imagawa Iichiro Shimomura
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.56, no.11, pp.1383-1385, 2017-06-01 (Released:2017-06-01)
- 参考文献数
- 14
- 被引用文献数
- 1 1
An impaired awareness of hypoglycemia is a serious problem in diabetic patients, which can lead to life-threatening severe hypoglycemia. Recurrent hypoglycemia attenuates the function of the central, mainly hypothalamic, nervous system and it causes an impaired awareness of hypoglycemia. Vitamin B12 deficiency is also associated with the dysfunction of central nervous system. We report a 72-year-old type 1 diabetic patient with vitamin B12 deficiency whose impaired awareness of hypoglycemia improved after 4 weeks of vitamin B12 administration with an increased counter-hormone secretion in response to hypoglycemia. We should recognize vitamin B12 deficiency as one of the causes of an impaired awareness of hypoglycemia in diabetic patients.