Hipoglucemia en pacientes diabéticos en tratamiento con glibenclamida

Abstract

Glibenclamide is a potent hypoglycemic agent that helps to maintain lower serum glucose levels in diabetics, which may confer a higher risk of hypoglycemia as an acute complication than with the use of other oral hypoglycemic agents, such as metformin. The purpose of this review is to collect and to summarize updated information on the mechanism of hypoglycemia in diabetic patients during treatment with glibenclamide, the risk factors that predispose diabetic patients to suffer hypoglycemia, and the frequency with which hypoglycemia may occur as adverse reaction during treatment of diabetes. Its mechanism of action consists of the inhibition of ATP-dependent potassium channels in the beta cells of the pancreas, where it stimulates the secretion of insulin by these cells. As its function is independent of serum glucose levels, hypoglycemia frequently manifests as an adverse effect of its administration. The effect of the drug is enhanced in cases such as patients with long-standing diabetes or comorbidities like kidney failure, the use of high doses or the use of other drugs that enhance its effect. Even though the use of glibenclamide as a cause of hypoglycemia is predicted to be underestimated, it is predicted that approximately 1 in 5 patients treated with this drug may experience hypoglycemia during the diabetes therapy. This factor directly influences the quality of life of the diabetic patient, as well as their adherence to hypoglycemic treatment, who chooses to abandon this medication or request a change in the scheme and the drug of choice for their therapy.