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Previous Volume 360:2482-2483 June 4, 2009 Number 23 Next

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To the Editor: In our letter to the Editor (Feb. 12 issue),¹ we reported on 150 nondiabetic patients with drug-induced hypoglycemia due to four brands of sexual-enhancement drugs that were contaminated with glyburide.

Two recent articles by some of the authors of our letter have appeared elsewhere. One article described the neuroglycopenic and adrenergic symptoms of severe hypoglycemia in 15 of these patients,² and the other described findings indicative of hypoglycemia on brain magnetic resonance imaging in 7 of these patients³; there were overlaps between these two groups of patients. The cases of hypoglycemia reported in both articles pertained only to the sexual-enhancement drug called Power 1 Walnut. We did not cite these articles, and we regret these omissions.

Shih Ling Kao, M.B., B.S., M.R.C.P.
National University Hospital
Singapore 119074, Singapore

Cheng Leng Chan, B.Sc. (Pharm.)
Belinda Tan, B.Sc. (Pharm.)
Health Sciences Authority
Singapore 138667, Singapore

C.C. Tchoyoson Lim, F.R.C.R., M.Med.
National Neuroscience Institute
Singapore 308433, Singapore

Rinkoo Dalan, M.R.C.P.
Tan Tock Seng Hospital
Singapore 308433, Singapore

Daphne Gardner, M.B., B.S., M.R.C.P.
Singapore General Hospital
Singapore 169608, Singapore

Edward Pratt, M.R.C.P.
Changi General Hospital
Singapore 529889, Singapore

Marilyn Lee, M.B., B.S., M.R.C.P.
Alexandra Hospital
Singapore 159964, Singapore

Kok Onn Lee, M.D.
National University Hospital
Singapore 119074, Singapore

References

1. Kao SL, Chan CL, Lim CC, et al. An unusual outbreak of hypoglycemia. N Engl J Med 2009;360:734-736. [Free Full Text]
2. Dalan R, Leow MK, George J, et al. Neuroglycopenia and adrenergic responses to hypoglycaemia: insights from a local epidemic of serendipitous massive overdose of glibenclamide. Diabet Med 2009;26:105-109. [CrossRef][Web of Science][Medline]
3. Lim CC, Gan R, Chan CL, et al. Severe hypoglycemia associated with an illegal sexual enhancement product adulterated with glibenclamide: MR imaging findings. Radiology 2009;250:193-201. [Free Full Text]

PDF PDA Full Text Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article by Kao, S. L. PubMed Citation

This article has been cited by other articles:

• Van Way, C. W. III (2009). Change Is in the Wind. Nutr Clin Pract 24: 433-435 [Full Text]