Severe hypoglycemia secondary to angiotensin-converting-enzyme inhibitors in the absence of diabetes mellitus. Report of a case
Elorriaga-Sánchez, F.; Corrales-Bobadilla, H.; Sosa-Trinidad, E.; Domínguez-Quezada, B.
Gaceta Medica de Mexico 137(3): 249-252
2001
ISSN/ISBN: 0016-3813 PMID: 11432094 Document Number: 7615
We present the first reported case of untreatable hypoglycemia in a woman of 66-years-old, non-diabetic who received captopril for six years, and more recently ramipril. Six months ago, she was seen for the first time in our hospital. We found her disoriented, sweaty and confusing words frequently. Glucose tolerance test one hour after administration of glucose: 53 mg/dl. Test of insulin and C peptide had norms the same as the other contra-regulator hormones except glucagon with moderate elevation. The B.P. increased and we changed to ramipril, which improved the pressure but the hypoglycemia persisted. A new change was made to Losartan plus hydrochlorothiazide; after 72 hours patient improved. A new glucose tolerance test one hour after administration of glucose is absolutely normal. General conditions of the patients are observed more than 3 months and are asymptomatic. The B. P. is normal and we are keeping only the recently installed treatment.
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