Published online Aug 16, 2013. doi: 10.12998/wjcc.v1.i5.169
Revised: June 20, 2013
Accepted: July 4, 2013
Published online: August 16, 2013
We report on a patient with type 1 diabetes mellitus who presented with recurrent episodes of hypoglycemia and a marked reduction in her daily insulin requirements after introduction of fluoxetine. This 25-year-old Caucasian woman had been followed up at the outpatient clinic for type 1 diabetes mellitus and pre-pregnancy care. She used a continuous subcutaneous insulin infusion with lispro and her daily insulin dose was 0.5 IU/kg per day. She had no chronic diabetic complications or hypoglycemia unawareness. Fluoxetine at a daily dose of 20 mg had been started because of depressive symptoms and within one week, she presented recurrent hypoglycemic episodes that prompted a progressive reduction in the insulin dose down to 0.3 IU/kg per day. The reduced insulin requirements continued during the period of fluoxetine treatment while glycated hemoglobin remained stable. She had no concurrent additional cause to explain the reduced insulin requirements. After fluoxetine was stopped, insulin requirements progressively increased and returned to the patient´s usual dose.
Core tip: A patient with type 1 diabetes mellitus presented with hypoglycemia and a marked reduction in insulin requirements associated with fluoxetine treatment. Hypoglycemia accompanying treatment with fluoxetine has been reported in patients with type 1 or type 2 diabetes mellitus. Healthcare professionals should be aware of this association for the sake of patient safety.