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As the clinical applications for calcium channel blockers have increased, so has the number of overdoses. These agents impair the release of insulin and increase insulin resistance, resulting in hyperglycemia, a hallmark of severe calcium channel blocker intoxication. In a retrospective case series, researchers reviewed records for all patients with a discharge diagnosis of verapamil or diltiazem overdose from five hospitals in New England to assess the association between hyperglycemia and a composite endpoint of death during hospitalization, need for a pacemaker, or need for vasopressors.
Of 40 overdose patients eligible for evaluation, 67.5% ingested verapamil, and 32.5% ingested diltiazem; sustained-release preparations were involved in …