What is the primary treatment for sulfonylurea toxicity?

The primary treatment for sulfonylurea toxicity involves administering intravenous dextrose and octreotide. Sulfonylureas work by stimulating insulin release from the pancreas, which can lead to significant hypoglycemia when overdosed. The immediate treatment goal is to correct the hypoglycemia.

Administering dextrose, which is a form of sugar, helps to rapidly increase blood glucose levels. In cases of sulfonylurea overdose, glucose alone may not be sufficiently effective for long-term management because the insulin release can be prolonged, leading to recurrent hypoglycemia. This is where octreotide, a somatostatin analog, comes into play. Octreotide inhibits insulin release from the pancreas, counterbalancing the effects of the sulfonylurea and helping to stabilize blood sugar levels after initial treatment with dextrose.

While intravenous insulin could also be used therapeutically in some cases of hyperglycemia or severe toxicity, its role is not the primary strategy in sulfonylurea toxicity treatment because it can further complicate the management of hypoglycemia. Oral glucose is typically not suitable for acute treatment in a setting where IV access is available and immediate intervention is required. Glucagon can be effective in