Management of sulfonylurea ingestions

In the majority of pediatric patients with an unintentional ingestion of a sulfonylurea, observation and, if necessary, intravenous glucose supplementation, are sufficient. However, with cases of persistent hypoglycemia or cases refractory to IV glucose supplementation, attempts to inhibit insulin secretion should be considered. Octreotide appears effective and safe. It may eliminate the need for prolonged infusions of hypertonic dextrose solutions and secondarily the risks associated with central line access. It has been successful in restoring euglycemia in cases refractory to glucose infusions. In the absence of octreotide, diazoxide remains a viable alternative to decrease insulin secretion.