Emergency management of oral hypoglycemic drug toxicity

There are several classes of oral diabetes medications available in the United States, including sulfonylureas, meglitinides, biguanides, glitazones, and alpha-glucosidase inhibitors. These different classes have various mechanisms of action, giving each class a unique potential for toxicity that necessitates a distinct approach to evaluation, treatment, and disposition of each class of drug. The practicing emergency physician must have an understanding of these differences to safely care for patients exposed to these medications.