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 bl eeding in a type 2 diabetic patient well controlled with glibenclamide. Aft er volume rescsucitation and transfusion with packed blood cells an infusio n of octreotide at 50 mcg/hr was started. It was decided to start a long te rm octreotide treatment and the potential effect on her glycemic control wa s studied. A 75 gram oral glucose tolerance test was performed in two conse cutive days with and then without octreotide infusion. With octreotide bloo d glucose was higher and insulin levels were lower. As clinical indications expand, situations will arise where patients with diabetes on sulfonylurea s may require octreotide with a conceivable dramatic worsening of glycemic control.