1例甲状腺功能减退患者出现瑞格列奈相关非典型低血糖

1例66岁甲状腺功能减退症的女性患者3年来一直口服左甲状腺素钠50μg,1次/d。患者近期诊断为2型糖尿病,加用瑞格列奈1mg,2次/d降糖治疗。服药1周后患者出现意识不清。实验室检查血糖2.3mmol/L,诊断为低血糖症。遂停用瑞格列奈,给予葡萄糖注射液后患者血糖水平升至3.9、5.1和8.7mmol/L,意识逐渐恢复。改用那格列奈120mg,3次/d治疗,患者未再发生低血糖。

Repaglinide-associated atypical hypoglycemia occurring in a patient with hypothyroidism

A 66-year-old woman with hyperthyroidism received levothyroxine sodium 50 μg once daily for three years. She was recently diagnosed with type II diabetes. Repaglinide 1 mg twice daily was added to her regimen. One week later,the patient developed unconsciouness. Laboratory testing showed a blood glucose level of 2. 3 mmol/L. Hypoglycemia was diagnosed and repaglinide was stopped. Glucose injection was given. Her blood glucose levels increased to 3. 9,5. 1,and 8. 7 mmol/L. Her consciouness gradually recovered. Her repaglinide therapy was replaced with neteglinide 120 mg thrice daily. And her hypoglycemia did not recur