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The risk of hypoglycemia is low in the absence of other drugs that lower blood glucose. [medical citation needed] Pioglitazone can cause fluid retention and peripheral edema. As a result, it may precipitate congestive heart failure (which worsens with fluid overload in those at risk). It may cause anemia.
The incidence of hypoglycemia due to complex drug interactions, especially involving oral hypoglycemic agents and insulin for diabetes, rises with age. Though much rarer, the incidence of insulin-producing tumors also rises with advancing age. Most tumors causing hypoglycemia by mechanisms other than insulin excess occur in adults. [citation ...
Pioglitazone makes cells (fat, muscle and liver) more sensitive to insulin, which means that the body makes better use of the insulin it produces. [1] Glimepiride is a sulphonylurea: it stimulates the pancreas to produce more insulin. [ 1 ]
Cause an average of 2–5 kg weight gain; Increase the risk of hypoglycemia; Glyburide increases risk of hypoglycemia slightly more compared to glimepiride and glipizide; Metformin: Acts on the liver to reduce gluconeogenesis and causes a decrease in insulin resistance via increasing AMPK signalling. Associated with weight loss
Pioglitazone (Actos), France and Germany have suspended its sale after a study suggested the drug could raise the risk of bladder cancer. [ 8 ] Rosiglitazone (Avandia), which was put under selling restrictions in the US and withdrawn from the market in Europe due to some studies suggesting an increased risk of cardiovascular events.
Some causes of hypoglycemia require treatment of the underlying cause to best prevent hypoglycemia. [2] This is the case for insulinomas which often require surgical removal of the tumor for hypoglycemia to remit. [2] In patients who cannot undergo surgery for removal of the insulinoma, diazoxide or octreotide may be used. [2]
Hypoglycemia can also be caused by sulfonylureas in people with type 2 diabetes, although it is far less common because glucose counterregulation generally remains intact in people with type 2 diabetes. Severe hypoglycemia rarely, if ever, occurs in people with diabetes treated only with diet, exercise, or insulin sensitizers.
If a patient using an alpha-glucosidase inhibitor suffers from an episode of hypoglycemia, the patient should eat something containing monosaccharides, such as glucose tablets. Since the drug will prevent the digestion of polysaccharides (or non-monosaccharides), non-monosaccharide foods may not effectively reverse a hypoglycemic episode in a ...