Sulfonylureas

• Sulfonylureas cause insuline release via cAMP/protein kinase C
• All sulfonylurea overdoses should be admitted for 24 hrs regardless of symptoms
• Antidote for recurrent hypoglycemia due to sulfonylureas (overdose or therapeutic misadventure) is octreotide, after your glucose
• Octreotide, a somatostatin analogue, turns of insulin secretion completely
• Octreotide 50 mcg SQ q 6 hrs for 24 hrs then observe for hypoglycemia 12-24 hrs

Fasono et al. Comparison of Octreotide and Standard Therapy Versus Standard Therapy Alone for the Treatment of Sulfonylurea-Induced Hypoglycemia. Ann Emerg Med 2007 Aug 29.