Drug-induced low blood sugar

Hypoglycemia - drug-induced; Low blood glucose - drug-induced

Drug-induced low blood sugar is low blood glucose that results from taking medicine.

Causes

Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes.

Other than certain medicines, the following can also cause blood sugar (glucose) level to drop:

Drinking alcohol
Getting more activity than usual
Intentionally or unintentionally overdosing on the medicines used to treat diabetes
Missing meals

Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in drug-induced low blood sugar. The condition may also occur when someone without diabetes takes a medicine used to treat diabetes. In rare cases, non-diabetes-related medicines can cause low blood sugar.

Medicines that can cause drug-induced low blood sugar include:

Beta-blockers (such as atenolol, or propranolol overdose)
Cibenzoline and quinidine (heart arrhythmia drugs)
Glinides (such as nateglinide and repaglinide)
Indomethacin (a pain reliever)
Insulin
Metformin when used with sulfonylureas
SGLT2 inhibitors (such as canagliflozin, dapagliflozin, empagliflozin and ertugliflozin) with or without sulfonylureas
Sulfonylureas (such as glipizide, glimepiride, glyburide)
Thiazolidinediones (such as pioglitazone and rosiglitazone) when used with sulfonylureas
Drugs that fight infections (such as gatifloxacin, levofloxacin, pentamidine, quinine, trimethoprim-sulfamethoxazole)

Open References

References

Cieslak J, Levin A, Beaulieu M. Management of patients with diabetes in the intensive care unit. In: Ronco C, Bellomo R, Kellum JA, Ricci Z, eds. Critical Care Nephrology. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 215.

Holt RIG. Diabetes mellitus. In: Feather A, Randall D, Waterhouse M, eds. Kumar and Clarke's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 23.

Food and insulin release - illustration
Insulin is a hormone secreted by the pancreas in response to increased glucose levels in the blood.
Food and insulin release
illustration

Food and insulin release - illustration
Insulin is a hormone secreted by the pancreas in response to increased glucose levels in the blood.
Food and insulin release
illustration

A Closer Look

Talking to your MD

Self Care

Pre-existing diabetes and pregnancy

Tests for Drug-induced low blood sugar

Review Date: 10/25/2022

Reviewed By: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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