diabetes mellitus. Hypoglycemia and hyperglycemia are two of these potential
a. Hypoglycemia ("Low Blood Sugar"). Hypoglycemia (also known as "low
blood sugar" or "insulin reaction") results from an overdose of insulin or an oral
hypoglycemic agent, from the too frequently administered insulin, from unaccustomed
exercise, or from a delayed or skimpy meal. In other words, there is insufficient glucose
present in the patient's blood. In this condition the diabetic speech becomes slurred
and the patient appears to be intoxicated. It is critical that this condition be properly
diagnosed by medical personnel. Hypoglycemia can be quickly treated. One, the
diabetic can be given a source of energy (e.g., a teaspoonful of sugar or a candy bar)
by mouth. Two, medical treatment personnel can administer glucagon injection, a
product that acts on liver glycogen in order to convert the glycogen to glucose.
b. Hyperglycemia ("Diabetic Coma"). Hyperglycemia ("diabetic coma" or
acidosis) results from the patient's neglecting to maintain proper dieting habits, the
patient's missing of required insulin doses, the patient's taking an underdose of insulin,
or from the patient's taking the insulin in doses that are too far apart. Hyperglycemia
can be treated with the administration of insulin. It is best that the patient's physician be
made aware of the patient's condition as soon as possible. This is necessary because
the patient's dosage of insulin might have to be changed.
Section IV. ORAL HYPOGLYCEMIC AGENTS
In individuals with maturity-onset diabetes mellitus, it is sometimes not necessary
to require the administration of insulin. Diet, in some instances can control the diabetes.
In other cases, the patient might have to take oral hypoglycemic agents to control the
diabetes mellitus. Oral hypoglycemic agents are not effective in the treatment of
juvenile-onset diabetes mellitus.
10-19. MECHANISM OF ACTION OF ORAL HYPOGLYCEMIC AGENTS
The oral hypoglycemic agents are sulfonylurea derivatives. These agents do not
increase the production of insulin in the beta cells of Islet of Langerhans. Instead, they
increase the secretion of insulin from the beta cells. The mechanism of this effect is not
known. Overall, the effect of these agents is to reduce the concentration of glucose in
the patient's blood.
10-20. POSSIBLE DRUG INTERACTIONS
A person who is taking an oral hypoglycemic agent may experience nausea,
vomiting, and abdominal pain (similar to that seen in disulfiram therapy) when alcohol is
consumed. Furthermore, patients who are on oral hypoglycemic therapy should be