With several new diabetes medications available, it is important to know which ones are likely to cause hypoglycemia after overdose. Based on mechanism of action and reported cases, the likelihood of hypoglycemia after overdose is listed below by drug class.
Keep in mind that other drugs can interact with antidiabetics resulting in hypoglycemia. This table applies only to single agent ingestion/administration.
Drug Class
Examples
Hypoglycemic Potential
Insulins
Glargine, Aspart, Detemir
High
Sulfonylureas
Glyburide, Glipizide
High
Meglitinides
Nateglinide, Repaglinide
High
Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists
Exenatide
Low-Moderate
Alpha-glucosidase inhibitors
Acarbose, Miglitol
Low
Thiazolidinediones
Rosiglitazone, Piaglitazone
Low
Biguanides
Metformin
Low
Dipeptidyl Peptidase 4 (DPP-4) Inhibitors
Sitagliptin, Saxagliptin
Low
References
Bosse GM. Chapter 48. Antidiabetics and Hypoglycemics. In: Bosse GM, ed. Goldfrank's Toxicologic Emergencies. 9th ed. New York: McGraw-Hill; 2011. http://www.accesspharmacy.com/content.aspx?aID=6514172. Accessed September 10, 2013.
