{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:11:56Z","timestamp":1761059516714,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Hypoglycaemia is a well-recognised untoward effect of sulfonylureas. We report a case of severe hypoglycaemia after isoniazid initiation in a type 2 diabetic patient. An oral glucose tolerance test revealed high serum insulin and C peptide, suggesting hyperinsulinaemia, and it was used to ascertain the relationship between insulin, glucose and C peptide levels. Insulin and C peptide elevation was attributed to the interaction between the two drugs. As a cytochrome inhibitor, isoniazid increased serum glimepiride concentration, resulting in hyperinsulinaemia. The diagnosis of occult insulinoma or nesidioblastosis was ruled out by CT and MRI, as we could not perform more sensitive, still invasive, diagnostic procedures. After isoniazid withdrawal, hypoglycaemia regressed and glimepiride was reinitiated. In conclusion, this case illustrates the need of caution when prescribing isoniazid in patients with type 2 diabetes mellitus receiving glimepiride to avoid hypoglycaemia.<\/jats:p>","DOI":"10.1136\/bcr-2012-008528","type":"journal-article","created":{"date-parts":[[2013,4,17]],"date-time":"2013-04-17T00:52:32Z","timestamp":1366159952000},"page":"bcr2012008528","source":"Crossref","is-referenced-by-count":12,"title":["Hypoglycaemia due to interaction of glimepiride with isoniazid in a patient with type 2 diabetes mellitus"],"prefix":"10.1136","volume":"2013","author":[{"given":"Panagiotis","family":"Boglou","sequence":"first","affiliation":[{"name":"Department of Pneumonology, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paschalis","family":"Steiropoulos","sequence":"additional","affiliation":[{"name":"Department of Pneumonology, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Papanas","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Demosthenes","family":"Bouros","sequence":"additional","affiliation":[{"name":"Department of Pneumonology, Democritus University of Thrace, Alexandroupolis, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,4,16]]},"reference":[{"key":"2025082706531952000_2013.apr16_1.bcr2012008528.1","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1210\/jc.2008-1410","article-title":"Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline","volume":"2013","author":"Cryer","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082706531952000_2013.apr16_1.bcr2012008528.2","first-page":"603","article-title":"Treatment of tuberculosis","volume":"2013","author":"American Thoracic Society, Centers for Disease Control and Prevention, and the Infectious Diseases Society of America.","year":"2003","journal-title":"Am J Respir Crit Care Med"},{"key":"2025082706531952000_2013.apr16_1.bcr2012008528.3","first-page":"32","article-title":"Hyperinsulinemia associated with normal C-peptide levels in a woman treated with isoniazide","volume":"2013","author":"Villaume","year":"1982","journal-title":"Biomed Pharmacother"},{"key":"2025082706531952000_2013.apr16_1.bcr2012008528.4","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.jdiacomp.2004.07.001","article-title":"The role of glimepiride in the effective management of type 2 diabetes","volume":"2013","author":"Davis","year":"2004","journal-title":"J Diabetes Complications"},{"key":"2025082706531952000_2013.apr16_1.bcr2012008528.5","doi-asserted-by":"crossref","first-page":"555","DOI":"10.2337\/diacare.10.5.555","article-title":"Efficacy of glyburide in diabetics poorly controlled on first generation oral hypoglycemics","volume":"2013","author":"Cohen","year":"1987","journal-title":"Diabetes Care"},{"key":"2025082706531952000_2013.apr16_1.bcr2012008528.6","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1007\/s00125-012-2534-0","article-title":"Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. 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