SMS 201-995 (Sandoz Pharmaceuticals. East Hanover NJ) is a synthetic peptide analog of native somatostatin that has been used to relieve .symptoms caused by neuroendocrine tumors. Reports have described an insulin suppressive effect of SMS 201-995 that results in elevations of blood glucose. We report a patient with a metastatic small bowel carcinoid and renal failure in whom mild symptomatic hypoglycemia occurred 30 to 60 minutes after SMS 201-995 administration. No increase in insulin or decreases in glucagon. Cortisol, or catecholamines were observed during these hypoglycemic episodes. Elevated levels of growth hormone fell gradually following SMS 201-995 administration and did not temporally correspond to the 30- to 60-minute nadir of blood glucose. However SMS 201-995 levels peaked during this 30- to 60-minute period. As clinical experience with this drug broadens, patients whose glucose control is dependent on counter-regulatory hormones should be monitored for the possibility of hypoglycemia.
Brunner, John E.; Kruger, Davida F.; Basha, Michael A.; Meiri, Eyal; and Kaatz, Scott S.
"Hypoglycemia After Administration of Somatostatin Analog (SMS 201-995) in Metastatic Carcinoid,"
Henry Ford Hospital Medical Journal
: Vol. 37
Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol37/iss2/2