International Journal of Health Sciences & Research (www.ijhsr.org) 407 Vol.7; Issue: 4; April 2017 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Review Article Awareness of Iatrogenic Hypoglycemia Secondary to Anti-Diabetic Agents in Diabetic Nephropathy: A Case Report and Review of Literature Akinbodewa Akinwumi Ayodeji 1 , Adejumo Oluseyi Ademola 2 , Adesina Fidelis Olubiyi 3 1 Kidney Care Centre, University of Medical Sciences, Medical Village, Ondo State, Consultant Nephrologist and Medical Director at Kidney Care Centre; 2 Kidney Care Centre, University of Medical Sciences, Medical Village, Ondo State, Consultant Nephrologist and Senior Lecturer; 3 Endocrine Unit, Department of Medicine, Federal Medical Centre, Abeokuta, Ogun State, Nigeria, Consultant Endocrinologist; Corresponding Author: Akinbodewa Akinwumi Ayodeji ABSTRACT Diabetes mellitus is now a major cause of chronic kidney disease with a prevalence of 11% to 83.7% in Africa. The presence of drug-induced hypoglycemia further increases the risk of death by 2-3 folds; a risk that is further heightened by the presence of nephropathy of which many diabetics are unaware due to poor screening practice by health workers in diabetes clinics. Sufficient data also exist to show that many diabetics have poor knowledge about harmful effects of anti-diabetic agents. We conducted electronic search of literature using various search engines such as MEDLINE, pub med, research gate, google scholar, cross-ref etc using keywords such as ‘nephropathy, diabetes, hypoglycemia, renal failure, iatrogenic, anti-diabetic agents’. We then identified the case of a 60 year old diabetic with subclinical undiagnosed severe chronic kidney disease (NKF-KDOQI stage 5) who presented to our Emergency Unit with hypoglycemic coma after he self-medicated on 5mg glibenclamide daily over 72 hours. Our review relates poor knowledge of diabetes and renal failure among diabetics and physicians to the danger of recurrent of hypoglycemia and increased risks of mortality. We conclude that diabetes clinics need to be properly structured to include special rooms for practice- oriented interactive sessions and audio-visual presentations; we suggest running multiple diabetes clinics in settings where the patient load is enormous; dieticians and trained Diabetes Health Educators should be integrated into the diabetes out-patient clinics. Keywords: hypoglycemia, iatrogenic, anti-diabetic agent, nephropathy INTRODUCTION The World Health Organization projects that diabetes mellitus will be the seventh leading cause of death by 2030. [1] Almost parallel to this is the rise in the prevalence of diabetic nephropathy; its prevalence is reported to be as high as 40% to 48.1%; in the United States, approximately 3% of persons with newly diagnosed type 2 diabetes have overt nephropathy. [2-4] A recent review of 32 studies in Africa showed prevalence rates of between 11% and 83.7% for diabetic nephropathy. [5] There are evidences to prove that diabetic patients have insufficient education about their disease, complications and treatment. [6] This may not be un- connected to the exponential rise of diabetes globally which has placed a distracting burden on diabetes clinic staff who have to contend not only with the disease but its attendant multi-systemic complications, each of which demands specialist care. This deficiency is further heightened in