Publisher Summary This chapter elaborates the different aspects of insulin, other hypoglycemic drugs, and glucagon. Glucagon has been used to assess adrenal function in 215 children who had fasted overnight. The risk of hypoglycemia in ICU has been studied retrospectively in 2,272 patients. Hypoglycemia was associated with diabetes, sepsis, a Sequential Organ Failures Assessment score of 1 or more, the use of bicarbonate in renal replacement, female sex, use of vasopressors or insulin, and impaired nutrition without altered insulin dosage. The type of insulin used may influence the frequency of hypoglycemia. Insulin detemir and glargine may reduce the incidence of hypoglycemia compared with NPH insulin, although results are variable. A review of seven nonrandomized studies of children aged 1–18 years showed a reduction in hypoglycemia, and it is suggested that diabetic ketoacidosis is not more of a problem if guidelines are followed. Four patients taking levothyroxine for hypothyroidism developed suppressed thyroid stimulating hormone concentrations when taking metformin. A meta-analysis has shown an increased risk of nasopharyngitis in patients taking dipeptidyl peptidase IV inhibitors.
