Octreotide-Induced Hypoglycemia in a Cirrhotic Patient

Abstract

The patient was briefly treated with high-dose octreotide (up to 200mcg every 8 hour), hydrochlorothiazide, and diazoxide when the etiology of his hypoglycemia was thought to be a result of excess insulin secretion. The hydrochlorothiazide and diazoxide were discontinued in the setting of hyperkalemia and worsening kidney function. There was no appreciable improvement in the patient's blood glucose levels until the octreotide was discontinued and high-dose steroids was initiated. The patient was weaned off of all continuous dextrose infusion about three weeks after he last received octreotide, and was subsequently discharged home one week later on prednisone 5mg once daily. As an outpatient, the patient was tapered off of prednisone.