Hypoglycemic Coma in a Hemodialysis Patient Receiving Blood Glucose-Lowering Therapy With the Single Agent Teneligliptin
Blood glucose management in patients undergoing dialysis is clinically challenging. In this population, most conventional oral hypoglycemic agents are contraindicated, especially from the perspective of pharmacokinetics. Dipeptidyl peptidase-4 inhibitors exert unique pharmacologic actions via glucos...
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doaj-40b5a120dcf04d03a9ee395d6fe836a32020-11-25T03:13:25ZengSAGE PublishingClinical Medicine Insights: Case Reports1179-54762018-03-011110.1177/1179547618763358Hypoglycemic Coma in a Hemodialysis Patient Receiving Blood Glucose-Lowering Therapy With the Single Agent TeneligliptinTakumi Minezumi0Shin-ichi Takeda1Yusuke Igarashi2Kentaro Sato3Yoshiaki Murakami4Daisuke Nagata5Department of Internal Medicine, Haga Red Cross Hospital, Moka, JapanDivision of Nephrology, Department of Medicine, Jichi Medical University, Shimotsuke, JapanDivision of Nephrology, Department of Medicine, Jichi Medical University, Shimotsuke, JapanDepartment of Internal Medicine, Haga Red Cross Hospital, Moka, JapanDepartment of Internal Medicine, Haga Red Cross Hospital, Moka, JapanDivision of Nephrology, Department of Medicine, Jichi Medical University, Shimotsuke, JapanBlood glucose management in patients undergoing dialysis is clinically challenging. In this population, most conventional oral hypoglycemic agents are contraindicated, especially from the perspective of pharmacokinetics. Dipeptidyl peptidase-4 inhibitors exert unique pharmacologic actions via glucose-dependent mechanism and have an excellent tolerability profile with a very low risk of hypoglycemia. Furthermore, the literature reports that some dipeptidyl peptidase-4 inhibitors such as teneligliptin can be administered at the usual dose, regardless of a patient’s level of renal impairment. In this article, we report a case of hypoglycemic coma with a blood glucose level of 23 mg/dL. The patient became fully conscious shortly after receiving a glucose injection; however, severe hypoglycemia recurred for approximately 1.5 days. It eventually disappeared on the discontinuation of teneligliptin, which was the only antidiabetic agent that he had received. The present case may provide deep insights into promoting the safe use of hypoglycemic agents in patients undergoing dialysis.https://doi.org/10.1177/1179547618763358 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Takumi Minezumi Shin-ichi Takeda Yusuke Igarashi Kentaro Sato Yoshiaki Murakami Daisuke Nagata |
spellingShingle |
Takumi Minezumi Shin-ichi Takeda Yusuke Igarashi Kentaro Sato Yoshiaki Murakami Daisuke Nagata Hypoglycemic Coma in a Hemodialysis Patient Receiving Blood Glucose-Lowering Therapy With the Single Agent Teneligliptin Clinical Medicine Insights: Case Reports |
author_facet |
Takumi Minezumi Shin-ichi Takeda Yusuke Igarashi Kentaro Sato Yoshiaki Murakami Daisuke Nagata |
author_sort |
Takumi Minezumi |
title |
Hypoglycemic Coma in a Hemodialysis Patient Receiving Blood Glucose-Lowering Therapy With the Single Agent Teneligliptin |
title_short |
Hypoglycemic Coma in a Hemodialysis Patient Receiving Blood Glucose-Lowering Therapy With the Single Agent Teneligliptin |
title_full |
Hypoglycemic Coma in a Hemodialysis Patient Receiving Blood Glucose-Lowering Therapy With the Single Agent Teneligliptin |
title_fullStr |
Hypoglycemic Coma in a Hemodialysis Patient Receiving Blood Glucose-Lowering Therapy With the Single Agent Teneligliptin |
title_full_unstemmed |
Hypoglycemic Coma in a Hemodialysis Patient Receiving Blood Glucose-Lowering Therapy With the Single Agent Teneligliptin |
title_sort |
hypoglycemic coma in a hemodialysis patient receiving blood glucose-lowering therapy with the single agent teneligliptin |
publisher |
SAGE Publishing |
series |
Clinical Medicine Insights: Case Reports |
issn |
1179-5476 |
publishDate |
2018-03-01 |
description |
Blood glucose management in patients undergoing dialysis is clinically challenging. In this population, most conventional oral hypoglycemic agents are contraindicated, especially from the perspective of pharmacokinetics. Dipeptidyl peptidase-4 inhibitors exert unique pharmacologic actions via glucose-dependent mechanism and have an excellent tolerability profile with a very low risk of hypoglycemia. Furthermore, the literature reports that some dipeptidyl peptidase-4 inhibitors such as teneligliptin can be administered at the usual dose, regardless of a patient’s level of renal impairment. In this article, we report a case of hypoglycemic coma with a blood glucose level of 23 mg/dL. The patient became fully conscious shortly after receiving a glucose injection; however, severe hypoglycemia recurred for approximately 1.5 days. It eventually disappeared on the discontinuation of teneligliptin, which was the only antidiabetic agent that he had received. The present case may provide deep insights into promoting the safe use of hypoglycemic agents in patients undergoing dialysis. |
url |
https://doi.org/10.1177/1179547618763358 |
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