Clinical presentation

Hypoglycaemia usually manifests within 6 to 12 hours after ingestion of a sulfonylurea drug, although delays of up to 18 hours in children have been reported.

Symptoms of hypoglycaemia may be blunted in patients with longstanding diabetes, but include:

• central nervous system effects—dizziness, confusion, headache, drowsiness, seizures, coma
• autonomic effects—tremor, tachycardia, sweating, nausea.

Patients may have symptoms of hypoglycaemia despite a normal blood glucose concentration, as symptoms can precede a marked drop in blood glucose concentration.