International Journal of Health Sciences and Research

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Review Article

Year: 2017 | Month: April | Volume: 7 | Issue: 4 | Pages: 407-415

Awareness of Iatrogenic Hypoglycemia Secondary to Anti-Diabetic Agents in Diabetic Nephropathy: A Case Report and Review of Literature

Akinbodewa Akinwumi Ayodeji1, Adejumo Oluseyi Ademola2, Adesina Fidelis Olubiyi3

1Kidney Care Centre, University of Medical Sciences, Medical Village, Ondo State, Consultant Nephrologist and Medical Director at Kidney Care Centre;
2Kidney Care Centre, University of Medical Sciences, Medical Village, Ondo State, Consultant Nephrologist and Senior Lecturer;
3Endocrine Unit, Department of Medicine, Federal Medical Centre, Abeokuta, Ogun State, Nigeria, Consultant Endocrinologist;

Corresponding Author: Akinbodewa Akinwumi Ayodeji


Diabetes mellitus is now a major cause of chronic kidney disease with a prevalence of 11% to 83.7% in Africa. The presence of drug-induced hypoglycemia further increases the risk of death by 2-3 folds; a risk that is further heightened by the presence of nephropathy of which many diabetics are unaware due to poor screening practice by health workers in diabetes clinics. Sufficient data also exist to show that many diabetics have poor knowledge about harmful effects of anti-diabetic agents. We conducted electronic search of literature using various search engines such as MEDLINE, pub med, research gate, google scholar, cross-ref etc using keywords such as ‘nephropathy, diabetes, hypoglycemia, renal failure, iatrogenic, anti-diabetic agents’. We then identified the case of a 60 year old diabetic with subclinical undiagnosed severe chronic kidney disease (NKF-KDOQI stage 5) who presented to our Emergency Unit with hypoglycemic coma after he self-medicated on 5mg glibenclamide daily over 72 hours. Our review relates poor knowledge of diabetes and renal failure among diabetics and physicians to the danger of recurrent of hypoglycemia and increased risks of mortality. We conclude that diabetes clinics need to be properly structured to include special rooms for practice-oriented interactive sessions and audio-visual presentations; we suggest running multiple diabetes clinics in settings where the patient load is enormous; dieticians and trained Diabetes Health Educators should be integrated into the diabetes out-patient clinics.

Key words: hypoglycemia, iatrogenic, anti-diabetic agent, nephropathy

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