Abstract：
BACKGROUND: Tigecycline has a broad spectrum of activity, including activity against drug-resistant Gram-positive and -negative microorganisms. Its side effects are significant, but hypoglycemia is a rare finding during treatment. We aim to present an event of severe hypoglycemia in a patient with type 2 diabetes mellitus with replacement renal therapy, and hemodialysis after initiating tigecycline.
METHODS: A 54-year-old female diagnosed with type 2 diabetes mellitus was under treatment with basal-bolus insulin therapy and oral antihypertensive drugs. She started hemodialysis 24 months ago. She complained of recurrent fever for the last seven months and was treated with several antibiotics. In two separate blood cultures, she tested positive for methicillin-resistant Staphylococcus epidermidis (MRSE). Based on the antibiogram, we started treatment with tigecycline 100 mg/day. After 6-8 hours from the first dose, the patient is complicated with events of hypoglycemia and then continues with severe hypoglycemia (40-47 mg/dL). The patient continued to have hypoglycemia for about 16-18 hours after the last dose. We didn\'t find any reasons to explain the cause of episodes of hypoglycemia. She did not have high blood insulin levels (insulin 4.11 mIU/L [range 2.6-24.9]). We followed her for six months and the patient did not experience episodes of hypoglycemia.
CONCLUSIONS: The association of severe hypoglycemia with tigecycline treatment is a very rare event and published papers on this topic are limited. Clinicians should be aware of this rare event when administering tigecycline and should routinely check blood glucose level during the treatment.
METHODS: A 54-year-old female diagnosed with type 2 diabetes mellitus was under treatment with basal-bolus insulin therapy and oral antihypertensive drugs. She started hemodialysis 24 months ago. She complained of recurrent fever for the last seven months and was treated with several antibiotics. In two separate blood cultures, she tested positive for methicillin-resistant Staphylococcus epidermidis (MRSE). Based on the antibiogram, we started treatment with tigecycline 100 mg/day. After 6-8 hours from the first dose, the patient is complicated with events of hypoglycemia and then continues with severe hypoglycemia (40-47 mg/dL). The patient continued to have hypoglycemia for about 16-18 hours after the last dose. We didn\'t find any reasons to explain the cause of episodes of hypoglycemia. She did not have high blood insulin levels (insulin 4.11 mIU/L [range 2.6-24.9]). We followed her for six months and the patient did not experience episodes of hypoglycemia.
CONCLUSIONS: The association of severe hypoglycemia with tigecycline treatment is a very rare event and published papers on this topic are limited. Clinicians should be aware of this rare event when administering tigecycline and should routinely check blood glucose level during the treatment.
摘要：
背景：替加环素具有广泛的活性，包括抗耐药性革兰氏阳性和阴性微生物的活性。它的副作用很大，但低血糖是治疗期间罕见的发现。我们的目的是在肾脏替代治疗的2型糖尿病患者中出现严重低血糖事件。开始使用替加环素后进行血液透析。
方法：一名被诊断为2型糖尿病的54岁女性正在接受基础推注胰岛素治疗和口服降压药治疗。24个月前她开始血液透析.她抱怨过去七个月反复发烧，并接受了几种抗生素治疗。在两个不同的血液培养中，耐甲氧西林表皮葡萄球菌(MRSE)检测呈阳性.根据抗菌谱,我们开始使用替加环素100mg/天治疗.从第一次给药6-8小时后，患者并发低血糖事件,然后继续出现严重低血糖(40-47mg/dL).患者在最后一次给药后持续约16-18小时具有低血糖。我们没有找到任何理由来解释低血糖发作的原因。她没有高血胰岛素水平（胰岛素4.11mIU/L[范围2.6-24.9]）。我们随访了她六个月，患者没有出现低血糖发作。
结论：严重低血糖与替加环素治疗的关联是非常罕见的事件，关于该主题的发表论文有限。临床医生在使用替加环素时应注意这一罕见事件，并应在治疗期间定期检查血糖水平。
方法：一名被诊断为2型糖尿病的54岁女性正在接受基础推注胰岛素治疗和口服降压药治疗。24个月前她开始血液透析.她抱怨过去七个月反复发烧，并接受了几种抗生素治疗。在两个不同的血液培养中，耐甲氧西林表皮葡萄球菌(MRSE)检测呈阳性.根据抗菌谱,我们开始使用替加环素100mg/天治疗.从第一次给药6-8小时后，患者并发低血糖事件,然后继续出现严重低血糖(40-47mg/dL).患者在最后一次给药后持续约16-18小时具有低血糖。我们没有找到任何理由来解释低血糖发作的原因。她没有高血胰岛素水平（胰岛素4.11mIU/L[范围2.6-24.9]）。我们随访了她六个月，患者没有出现低血糖发作。
结论：严重低血糖与替加环素治疗的关联是非常罕见的事件，关于该主题的发表论文有限。临床医生在使用替加环素时应注意这一罕见事件，并应在治疗期间定期检查血糖水平。
