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Am J Emerg Med. 2010 Oct;28(8):952-5. doi: 10.1016/j.ajem.2009.08.025. Epub 2010 Mar 25.

Quantitative insulin and C-peptide levels among ED patients with sulfonylurea-induced hypoglycemia-a prospective case series.

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  • 1Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA.



The objective of this study was to measure the serum insulin and C-peptide concentrations among diabetic patients known to be taking sulfonylurea agents who presented to the emergency department with hypoglycemia thought to be due to therapeutic usage as opposed to overdose. A recently published systematic review of 22 articles involving 76 patients with sulfonylurea-induced hypoglycemia (glucose <49 mg/dL) resulting from accidental ingestion or intentional overdose found that patients had an average serum insulin concentration of 3.9 μIU/mL or higher and an average serum C-peptide concentration of 1.4 ng/mL or higher.


This is a prospective cross-sectional descriptive case series.


Thirteen of 14 study subjects had initial insulin and C-peptide levels consistent with the diagnosis of sulfonylurea-induced hypoglycemia as previously defined among patients presenting after overdose.


Patients presenting with hypoglycemia resulting from therapeutic sulfonylurea use demonstrate similar insulin and C-peptide levels as has previously been published among patients who presented with presumed overdose.

Copyright © 2010 Elsevier Inc. All rights reserved.

[PubMed - indexed for MEDLINE]
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