Page 108 - ITPS-8-2

INNOSC Theranostics

and Pharmacological Sciences

CASE REPORT
Drug-induced hypoglycemia in a patient

with Type 2 diabetes and renal impairment: A
case report

Sara Shreen*, Mir Wajahath Ali, Mohammed Arshad Khan,
Sulaiman Abdul Majeed, and Mohammed Misbah Ul Haq
Department of Pharmacy Practice, Deccan School of Pharmacy, Hyderabad, Telangana, India

Abstract

Hypoglycemia is a serious adverse effect in the pharmacological treatment of
Type 2 diabetes mellitus (T2DM), exacerbated by comorbidities that affect drug
metabolism and clearance. This report describes a case involving a 61-year-
old man with hypertension and T2DM. The patient experienced hypoglycemia
while taking a combination of voglibose and metformin hydrochloride. His
condition was further complicated by urosepsis, acute-on-chronic kidney disease,
and hydroureteronephrosis calculi, which likely altered drug clearance and
pharmacokinetics. This condition increased his risk of hypoglycemia. Effective
management required close monitoring of blood glucose levels and adjustments to
the treatment regimen, considering his renal impairment. This case highlights the risks
*Corresponding author:
Sara Shreen associated with combination therapy in patients with renal issues and underscores
(sara4hussain12@gmail.com) the importance of personalized treatment plans, vigilant glucose monitoring, and
Citation: Shreen S, Ali MW, consideration of renal function to reduce the risk of drug-induced hypoglycemia in
Khan MA, Majeed SA, patients with T2DM and comorbidities.
Misbah Ul Haq M. Drug-induced
hypoglycemia in a patient with
Type 2 diabetes and renal Keywords: Hypoglycemia; Combination therapy; Renal impairment; Glycemic control;
impairment: A case report. INNOSC Type 2 diabetes mellitus
Theranostics and Pharmacological
Sciences. 2025;8(2):102-107.
doi: 10.36922/itps.7355
Received: August 16, 2024 1. Introduction
Revised: November 21, 2024
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose
Accepted: December 17, 2024
levels due to insufficient insulin production or ineffective insulin action. It is a global
Published online: January 3, 2025 health concern, affecting approximately 463 million adults worldwide in 2019, and the
1
Copyright: © 2025 Author(s). prevalence projected to increase to 700 million by 2045. In managing Type 2 diabetes
This is an Open-Access article mellitus (T2DM), optimal glycemic control must be maintained to prevent complications
distributed under the terms of the 2
Creative Commons Attribution such as cardiovascular disease, nephropathy, retinopathy, and neuropathy.
License, permitting distribution,
and reproduction in any medium, Pharmacotherapy is essential for achieving glycemic control in patients with T2DM.
provided the original work is Classes of antidiabetic agents, including biguanides, sulfonylureas, dipeptidyl peptidase-4
properly cited. (DPP-4) inhibitors, and alpha-glucosidase inhibitors, target different pathways involved
3
Publisher’s Note: AccScience in glucose metabolism. Combination therapy, involving the concurrent use of multiple
Publishing remains neutral with antidiabetic agents with complementary mechanisms of action, is frequently employed
regard to jurisdictional claims in
published maps and institutional to achieve better glycemic control in patients who do not respond adequately to
affiliations. monotherapy. 4,5

Volume 8 Issue 2 (2025) 102 doi: 10.36922/itps.7355