Kenneth E. Sherman, PhD, MD; Michael Bornemann, MD
Sherman KE, Bornemann M. Amitriptyline and Asymptomatic Hypoglycemia. Ann Intern Med. 1988;109:683-684. doi: 10.7326/0003-4819-109-8-683_2
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Published: Ann Intern Med. 1988;109(8):683-684.
To the Editor: Hypoglycemic unawareness may occur in diabetic patients with autonomic neuropathy or during treatment with beta-adrenergic blockers. Tricyclic antidepressants are frequently given to diabetic patients to treat peripheral neuropathy or depression, or both, and have not been reported to cause hypoglycemic unawareness. We describe a case of hypoglycemic unawareness in a patient with type I diabetes mellitus receiving treatment with amitriptyline whose symptoms resolved after the medication was withdrawn.
A 24-year-old woman who had had type I diabetes mellitus for 8 years, complicated by frequent episodes of ketoacidosis, proliferative retinopathy, and bilateral lumbar sympathectomy for reflex sympathetic dystrophy,
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