De Vigan C, Delporte M P, Thomas M, Perrault M
Nouv Presse Med. 1976 Apr 3;5(14):906-10.
The authors present 21 cases of severe hypoglycaemic side effects in diabetics treated with oral sulphonylurea drugs, including two deaths. The medications involved the most frequently were glibenclamide followed by glybutamide and glicalzide. Such side effects often occur early and are unrelated to dose. The classical predisposing factors were noted : old age, renal insufficiency, hepato-cellular insufficiency, drug associations -- in particular oral anticoagulants and salicylates. The indications for such drugs in the treatment of diabetes are discussed. Their use seems doubly illogical in the case of late onset obesity diabetes since the latter is accompanied by cardiovascular complications. It is dangerous in the elderly, particularly sensitive to the risks of hypoglycaemia and in who the diagnosis of "diabetes" is too often made on inadequate grounds.
作者报告了21例口服磺脲类药物治疗的糖尿病患者出现严重低血糖副作用的病例,其中包括两例死亡。涉及最多的药物是格列本脲,其次是格列吡嗪和格列齐特。此类副作用常早期出现且与剂量无关。注意到了典型的易感因素:老年、肾功能不全、肝细胞功能不全、药物联用——尤其是口服抗凝剂和水杨酸盐。讨论了此类药物在糖尿病治疗中的适应证。对于晚发性肥胖型糖尿病患者,使用这类药物似乎尤其不合理,因为后者伴有心血管并发症。在老年人中使用很危险,他们对低血糖风险特别敏感,而且常常在诊断“糖尿病”依据不足的情况下就进行用药。