Hypoglycemia associated with fluoxetine treatment in a patient with type 1 diabetes

Table 1 Summary of studies addressing fluoxetine and glucose metabolism

Reference	Study design	Results
Deeg et al[7]	Case report, patient with type 2 DM	Repeated episodes of hypoglycemia in a patient treated with glyburide. Fasting hypoglycemia (with hyperinsulinemia) continued 2 wk after glyburide was suspended and while receiving fluoxetine
Khoza et al[8]	Case reports, review of published reports	17 patients with glucose dysregulation (9 hyperglycemia; 8 hypoglycemia, one of them with fluoxetine) after initiation of treatment with antidepressant agents The authors concluded it was not clear whether changes in glucose regulation were due to antidepressants or to changes in mood and lifestyle
Sawka et al[9]	Case report, patient with type 1 DM	Reduced insulin requirements and hypoglycemia unawareness during treatment with fluoxetine
Maheux et al[10]	Experimental design, obese subjects with type 2 DM	Fluoxetine improved insulin sensitivity in a clamp study, independent of weight loss
Potter van Loon et al[11]	Experimental design, obese subjects with and without type 2 DM	Fluoxetine improved hepatic and peripheral insulin sensitivity in a clamp study
Lear et al[12]	Case report, patient with type 1 DM	Fluoxetine side effects mimicked hypoglycaemia
Fernández López et al[13]	Case report, non-diabetic woman	Clinical presentation with symptoms of hypoglycemia but without analytical confirmation
Briscoe et al[14]	Experimental design, patients with type 1 DM	6-wk administration of fluoxetine amplified autonomic nervous system and metabolic counter-regulatory mechanisms during moderate hypoglycemia.
Erenmemisoglu et al[15]	Experimental design, healthy and alloxan-induced diabetic mice	Fluoxetine and sertraline did not modify insulin concentrations but reduced plasma glucose
Gomez et al[16]	Experimental design, diabetic and non-diabetic rats	Sertraline prevented the increase in glycemia induced by an oral glucose load while fluoxetine had the opposite effect
Kesim et al[17]	Experimental design, healthy and diabetic mice	Paroxetine and fluoxetine had no significant or controversial effects on glycemia

DM: Diabetes mellitus.