Massive Glibenclamide Overdose without Hypoglycaemia in a Man with Diabetes after Partial Pancreatectomy

Abstract
A 49-year-old man with non-insulin-dependent diabetes mellitus (NIDDM) from alcoholic pancreatitis took 100 mg of glibenclamide without symptoms of hypoglycaemia even when glibenclamide concentrations were high (191 μg/l). There was no increase in serum C-peptide concentration. The observed half-life of glibenclamide was 6 h. It is concluded that (1) high doses of glibenclamide will not provoke pancreatic insulin secretion in NIDDM caused by pancreatic destruction, (2) there was no evidence for an acute extra-pancreatic effect of glibenclamide and (3) the elimination of glibenclamide may be slower than supposed previously.