SUN-625 Valsartan Induced Severe Hypoglycemia in a Non-diabetic Patient

Abstract Disclosure: M.A. Calle Prado: None. A. Khorochkov: None. I.K. Logvinsky: None. M. Delibasic: None. Background: Valsartan is used in the treatment of hypertension, heart failure and type 2 diabetes associated nephropathy. It relaxes blood vessels to lower blood pressure and improve cardiovascular outcomes including reducing risks of stroke, myocardial infarction and progression of heart failure. It also helps slows the progression of diabetic nephropathy due to its nephroprotective effects. Common side effects are dizziness, headache, fatigue, and nausea. However, it can affect glucose homeostasis in nondiabetic patients resulting in hypoglycemia a rare side effect. Case: A 76-year-old male presented to the emergency department after loss of consciousness without prodromal symptoms of dizziness, diaphoresis, or blurry vision and was found to have a glucose level of 29. Hypoglycemia improved with 50 mL of D 50 injection X2 to 94. Serum insulin level initially elevated at 25.60, with follow-up levels within normal limits of 5.4 and 7.4. Insulin-like growth factor 1 (IGF-1) was 134, beta hydroxybutyrate 0.15, and Insulin-like growth factor 2 (IGF-2) was 526, within normal limits. C peptide was normal at 2.33. MRI of the Abdomen without contrast showed no evidence of insulinoma. Despite testing, the patient had repeated episodes of hypoglycemia with levels ranging from 35-55. Decision Making: He experienced frequent episodes of low blood sugar every day, even though he was eating a healthy diet and taking supplements. After consulting with the pharmacy about patient’s drug history, we decided to hold valsartan as there is existing literature showing association of valsartan with hypoglycemia. After that, the patient did not experience hypoglycemia in the hospital. He was discharged and, during follow-up, no further hypoglycemic events occurred. Conclusion / Final results: After investigating the potential causes of the patient's recurrent hypoglycemic episodes, the pharmacy assisted in determining that Valsartan was the main culprit. Valsartan may impact glucose metabolism and insulin sensitivities in non-diabetic patients. Patients must monitor their blood sugar levels carefully while taking valsartan and address any concerns with their healthcare provider. Presentation: Sunday, July 13, 2025