Which Anti-Diabetes Medicines can Cause Low Blood Sugars or Hypoglycemia?

What is Hypoglycemia ?

When blood glucose level falls below 70mg/dl, person feels dizziness, headaches, sweating, confusion, anxiety symptoms, which relieve immediately after restoring blood glucose level to normal is known as Hypoglycemia.

Hypoglycemia
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Common Symptoms of Hypoglycemia includes :

  1. Adrenergic Symptoms of hypoglycemia :

    • Hunger
    • Faintness
    • Weakness
    • Sweating
    • Palpitations
    • Tremors
    • Tingling
    • Nervousness
    • Numbness around mouth

     

  2. Neuro-glycopenic Symptoms : may require help or assistance from another person.

    • Headache
    • Double Vision
    • Lack of co-ordination
    • Inappropriate behavior
    • Confusion
    • seizures
    • Coma
    • Permanent Brain Damage & Death

Which Anti-Diabetes Medicines can cause Low blood Sugars or Hypoglycemia?

Most common is Insulin. Any type of insulin or its analogues can cause hypoglycemia.

Most commonly used insulin includes Premixes like Mixtard 30/70, Huminsulin 30/70, Novomix 3o, Humalog 25/75, regular insulin like Human Actrapid, Huminsulin R. etc or Fast acting analogues like Novorapid, Apidra, Humalog etc

Long & intermediate acting insulin & analogues like Glargine (Lantus), Detemir ( Levemir) Degludec (Tresiba), NPH, Huminsulin N etc.

In case of oral medication, those oral anti-diabetes tablets which increases insulin secretion (insulin secretagogues) from pancreas can cause hypoglycemia.

Most commonly used Insulin secretagogues includes:

  1. Sulphonyureas:

    • Glibenclamide – Daonil, Glucored, Semi daonil, etc.
    • Glimeperide – Amaryl, Zoryl, Glimestar, Glimy, Azulix, Euglim, Glimiprex, Glucoryl, etc.
    • Gliclazide – Reclide, meclazide, diamicron, Glizid, Diabend, Dianorm, Glycinorm, etc.
    • Glipizide – Glynase, Semi-glynase, Lipi, etc.
  2. Glinides:

  • Repaglinide – Eurepa, Novonorm, Repa, Regan, etc.
  • Nateglinide – Glinate, Natiz, etc.

Other anti diabetic medicines like metformin (Glyciphage, Cetapin, Metsmall, etc.), Pioglitazone (Pioz, piopar, etc.), Alfa – glucosidase inhibitors like voglibose ( PPG, Volibo, Advog, Prandial,Volix, etc.), Acarbose (Glucobay, etc.),  DPP4 inhibitors including sitagliptin ( Zita, Istavel, Januvia, etc), Viladgliptin ( Galvus, Zomelis, etc) , Saxagliptin ( Onglyza), Linagliptin ( Trajenta) , Teneligliptin (zetaplus, tenglyn, dynaglipt) even newer addition to the list SGLT2 Inhibitors like Empagliflozin (jardiance, gibtulio), Dapagliflozin (forxiga, oxra, glidepa), canagliflozin (sulisent, invokana) or remogliflozin (remo, remozen, zucator, reniva) , DO NOT Cause Hypoglycemia when given alone or in monotherapy but can cause hypoglycemia when given in combination with insulin secretagogues or with insulin.

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Awareness is Prevention.

Dr. Nikhil Prabhu ( Diabetes Specialist )

Dr Nikhil Prabhu is a consultant Diabetologist from mumbai. he has been practicing for more than 10 years and currently over 7000 patients are under his treatment for diabetes and thyroid disorder from mumbai and navi mumbai area. | you can book his appointment for tele-consultation on 9082523295 | follow us on YouTube for more diabetes & health related tips

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