Sulfonylurea-induced hypoglycaemia

Hypoglycaemia can be due to a sulfonylurea (glibenclamide, gliclazide, glimepiride, glipizide) whether a patient is taking it with or without insulin. If hypoglycaemia occurs, the patient should be advised to self-monitor their blood glucose concentration more frequently until it increases to normal (see Nonsevere hypoglycaemia in patients with diabetes for management of the hypoglycaemia). If the patient is taking a long-acting sulfonylurea (eg glibenclamide, glimepiride) and/or has chronic kidney disease, hypoglycaemia may be prolonged and monitoring should continue for 24 hours or longer.

If the patient is using insulin and taking a sulfonylurea, hypoglycaemia is likely to be more marked. Blood glucose concentrations should be monitored frequently for 24 hours or longer, depending on the patient’s kidney function. See Severe hypoglycaemia in patients with diabetes for management. Consider other underlying causes for the hypoglycaemia, particularly deteriorating kidney function.

For a sulfonylurea overdose, stop the drug and arrange hospital admission and treatment (often prolonged). For further information on management of sulfonylurea-induced hypoglycaemia due to overdose, see Sulfonylurea poisoning.