The effect of octreotide on glucose and insulin levels in a patient with type 2 diabetes on glibenclamide

We report the case of a 35 year-old woman with recurent gastrointestinal bleeding in a type 2 diabetic patient well controlled with glibenclamide. After volume rescsucitation and transfusion with packed blood cells an infusion of octreotide at 50 mcg/hr was started. It was decided to start a long term octreotide treatment and the potential effect on her glycemic control was studied. A 75 gram oral glucose tolerance test was performed in two consecutive days with and then without octreotide infusion. With octreotide blood glucose was higher and insulin levels were lower. As clinical indications expand, situations will arise where patients with diabetes on sulfonylureas may require octreotide with a conceivable dramatic worsening of glycemic control.