From the Guidelines
Octreotide should not be used to treat hypoglycemia, as it can worsen hypoglycemia in certain situations, such as insulinoma, by suppressing counterregulatory hormones like growth hormone, glucagon, and catecholamines 1.
Clinical Considerations
When considering the treatment of hypoglycemia, it is essential to prioritize the use of glucagon, especially in individuals who are unable or unwilling to consume carbohydrates by mouth 1.
- Glucagon is the preferred treatment for hypoglycemia in these situations, and its use should be instructed to those in close contact with individuals at risk of hypoglycemia.
- Octreotide, on the other hand, is not recommended for the treatment of hypoglycemia due to its potential to worsen hypoglycemia in certain clinical scenarios.
Treatment Alternatives
For the treatment of hypoglycemia, the following alternatives should be considered:
- Glucagon, which can be administered intranasally or via ready-to-inject preparations, is the preferred treatment for hypoglycemia in individuals who are unable or unwilling to consume carbohydrates by mouth 1.
- Other treatments, such as dietary adjustments and diazoxide, may also be considered for the management of hypoglycemia, particularly in cases of insulinoma 1.
From the FDA Drug Label
Octreotide acetate injection alters the balance between the counter-regulatory hormones, insulin, glucagon and growth hormone (GH), which may result in hypoglycemia or hyperglycemia. The hypoglycemia or hyperglycemia which occurs during octreotide acetate injection therapy is usually mild, but may result in overt diabetes mellitus or necessitate dose changes in insulin or other hypoglycemic agents Symptomatic hypoglycemia, which may be severe, has been reported in these patients
Octreotide is not used to treat hypoglycemia. In fact, it may cause hypoglycemia as a side effect in some patients, particularly those with concomitant Type I diabetes mellitus. Therefore, it is not recommended to use octreotide to treat low blood sugar 2.
From the Research
Use of Octreotide in Treating Hypoglycemia
- Octreotide, a somatostatin analogue, has been used to treat hypoglycemia (low blood sugar) in various clinical settings 3, 4, 5, 6.
- In cases of sulfonylurea-induced hypoglycemia, octreotide has been shown to be effective in inhibiting insulin secretion and restoring euglycemia 3, 4.
- Octreotide has also been used to treat congenital hyperinsulinism (CHI), a condition characterized by excessive insulin secretion, with some studies suggesting its use in combination with glucagon infusion 7, 6.
- The efficacy of octreotide in treating hypoglycemia has been demonstrated in various studies, with some showing its ability to reduce the need for prolonged infusions of hypertonic dextrose solutions and central line access 3, 4.
Mechanism of Action
- Octreotide works by inhibiting the secretion of insulin and other neuropeptides, thereby reducing glucose uptake and increasing glucose release from stored energy sources 4, 5.
- The dose and route of administration of octreotide can affect its efficacy, with continuous subcutaneous infusion showing promise in reducing blood glucose and counterregulatory hormone concentrations 5.
Clinical Applications
- Octreotide has been used in various clinical settings, including the treatment of sulfonylurea-induced hypoglycemia, congenital hyperinsulinism, and insulin-dependent diabetes mellitus 3, 7, 4, 5, 6.
- Its use has been shown to be effective in reducing hypoglycemic episodes and improving glycemic control, making it a potential therapeutic option for patients with severe and persistent hypoglycemia 3, 4, 6.