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1例69岁女性2型糖尿病患者因突发言语不清和口角歪斜入院。入院前服用格列齐特80 mg,2次/d和阿司匹林0.1 g,1次/d。查血糖:1.7 mmol/L。给予50%葡萄糖100 ml静脉注射。1 h后血糖升至20 mmol/L,症状缓解。停用格列齐特,改为格列吡嗪缓释片5 mg,1次/d。次日,患者空腹血糖1.7 mmol/L、餐后血糖2.7 mmol/L,并有心慌、头晕等症状。静脉滴注10%葡萄糖250 ml后症状好转。入院第3～5天停用降糖药,患者血糖维持在空腹8.2 mmol/L、餐后10.1 mmol/L左右。第6天再用格列吡嗪缓释片5 mg,1次/d,血糖维持在5.5～6.5 mmol/L。2 d后患者出院,继续服用格列吡嗪缓释片。出院12 d,患者再次突发意识丧失,呼之不应,遂再次入院。查血糖示:1.6 mmol/L。入院第3天开始给予二甲双胍治疗,餐后2 h血糖维持在8.7 mmol/L左右。第9天患者出院。
A 69-year-old woman with type 2 diabetes admitted to hospital for sudden ill-defined speech and skewed speech. Before admission to taking gliclazide 80 mg, 2 times / d and aspirin 0.1 g, 1 / d. Check blood sugar: 1.7 mmol / L. Give 100% glucose 100 ml intravenously. Blood glucose rose to 20 mmol / L after 1 h, the symptoms relieved. Gliclazide was discontinued, instead of glipizide sustained-release tablets 5 mg, 1 time / d. The next day, patients with fasting blood glucose 1.7 mmol / L, postprandial blood glucose 2.7 mmol / L, and palpitation, dizziness and other symptoms. After intravenous infusion of 10% glucose 250 ml symptoms improved. Hypoglycemic agents were discontinued on the 3rd and 5th days after admission. The blood glucose of the patients was maintained at 8.2 mmol / L fasting and 10.1 mmol / L postprandial. On the 6th day, the glipizide sustained-release tablets were treated with 5 mg once daily for 5.5-6.5 mmol / L. Patients were discharged after 2 days and continue taking glipizide sustained-release tablets. Discharged 12 days, the patient suddenly unconsciousness, call should not, then again admitted to hospital. Check blood sugar showed: 1.6 mmol / L. Metformin was given on the third day after admission, and blood glucose was maintained at about 8.7 mmol / L at 2 hours after meal. On the 9th day the patient was discharged.