高齢糖尿病患者にみられたブホルミンによる低血糖の1例

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The patient was a 91 year-old female with diabetes mellitus, vascular dementia, depression and advanced arteriosclerosis. She had been treated with gilbenclamide (7.5 mg/day) and voglibose (0.9 mg/day). But her diabetic condition was gradually aggravated and she was given buformin (150 mg/day), one of biguanides, added to above 2 drugs. Hypoglycemic attacks developed at 10th day after buformin administration and lasted for 3 days. The dosage of buformin was reduced to a quarter (37. 5 mg/day) and a half (75 mg/day), but at 20th day after reduced dosage, hypoglycemic episodes developed again and lasted for 2 days. Now her diabetic condition was controlled by glibenclamide (2.5 mg/day) and buformin (75 mg/day). It seems that these hypoglycemic attacks might be caused by a synereistic effect of accumulation of buformin in the tissues and insulin activity of sulfonylurea. Attention might be paid to the adverse effect even in drugs with rare occurrence of adverse effects in aged patients.
香川県立保健医療大学の論文