PREBEN ELLING, M.D.; HANNE ELLING
To the editor: D-Penicillamine is a useful anti-rheumatoid arthritis drug with many side effects, but to date no effect of this drug on carbohydrate metabolism has been reported. We have recently seen two cases of unexplained hypoglycemia in insulin-dependent diabetics when penicillamine was used with their usual insulin dosage.
A 60-year-old man had been treated for nearly 30 years with a stable dose of insulin (Insulin Retard [NPH], 40 units/d). He had never had any hypoglycemic reactions, but 8 weeks after receiving penicillamine, 250 mg/d, for a seropositive erosive rheumatoid arthritis, he had severe attacks of typical hypoglycemic symptoms including
ELLING P, ELLING H. Penicillamine, Captopril, and Hypoglycemia. Ann Intern Med. 1985;103:644–645. doi: 10.7326/0003-4819-103-4-644
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Published: Ann Intern Med. 1985;103(4):644-645.
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