Reactions 1680, p183 - 2 Dec 2017 Hypoglycaemia in an elderly: case report A 78-year-old woman developed hypoglycaemia due to potentiation of hypoglycaemic action of premixed analogue insulin [specific type of insulin not stated] by saroglitazar which was administered for dyslipidaemias. The woman, who had sedentary lifestyle, and type 2 diabetes mellitus for 17 years, was previously treated with various oral antidiabetics and statins at other clinics. On her first visit to the present clinic, she had fasting plasma glucose (FPG) of 314 mg/dL and post prandial glucose (PPG) of 409 mg/dL, respectively. Her HbA1c was 8.7%, body weight was 60kg and BP was 150/94mm Hg. Her lipid profile showed out of range total cholesterol, LDL, HDL and triglycerides. She received a prescription of SC injection premixed analogue insulin (30/70), telmisartan and simvastatin. On her second visit, her FPG and PPG were still out of control, hence her insulin dose was increased with addition of linagliptin. On her third visit at three months, her FPG, PPG, HbA1c and lipid profile were still uncontrolled. Hence, her insulin dose was increased further; linagliptin and atorvastatin were continued. She was additionally prescribed with saroglitazar 4mg [route not stated] for glycaemic as well as lipid parameter control. On her fourth visit at four months, she was advised to continue with her ongoing medications. Three weeks after the fourth visit, she reported early morning hypoglycaemia with random plasma glucose of 69 mg/dL. The woman was advised to reduce the dose of her insulin and to report her glucose levels after seven days. Her FPG and PPG were 90 mg/dL and 188 mg/dL, respectively, after seven days. Her insulin dose was slightly adjusted. On her subsequent visits, FPG, PPG and HbA1c exhibited improving trends and the dose of insulin was adjusted accordingly. At follow-up visit, 12 months after her first presentation, she had good glycaemic control with FPG of 94 mg/dL, PPG of 146 mg/dL and HbA1c of 6.87%. She had no further hypoglycaemic episode. Marked improvement in her lipid profile was also noted. With insulin dosage adjustment she was advised to continue her ongoing medications. Author comment: "The addition of saroglitazar to insulin therapy may potentiate the hypoglycemic action of insulin which may necessitate reducing the dose of insulin to prevent hypoglycemic episodes." Chatterjee AK. Saroglitazar may reduce the requirement of insulin dose during the treatment of diabetic dyslipidemia. IHJ Cardiovascular Case Reports (CVCR) 1: 116-118, No. 3, Oct-Dec 2017. Available from: URL: http://doi.org/10.1016/ j.ihjccr.2017.09.003 - India 803284483 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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