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January 1965

Protracted Tolbutamide-Induced Hypoglycemia

Author Affiliations


From the Medical Service of The Menorah Medical Center.

Arch Intern Med. 1965;115(1):53-56. doi:10.1001/archinte.1965.03860130055009

TOLBUTAMIDE is a sulfonylurea compound that is widely used as an effective hypoglycemic agent. Hypoglycemic reactions during its use are usually shortlived and easily controlled. However, isolated cases of severe and protracted hypoglycemia due to tolbutamide have been reported. Some have terminated fatally or resulted in permanent neuropsychiatric deficits.

Because of the rarity of such reactions, the report of an additional case appears justified.

Report of Case  A 77-year-old tailor was admitted to Menorah Medical Center on Aug 4, 1963, because of precordial pain unrelieved by nitroglycerin.The patient had been known to have systolic hypertension since 1955. The same year the patient was digitalized because of episodes of shortness of breath at night and since then maintained on gitaligin 0.5 mg daily. In 1955 the patient had developed pain and swelling in both wrists and primary interphalangeal joints and was given prednisone 5 mg twice daily. Since this medication