Cutaneous Drug Reaction in a Nigerian Adult on Oral Antidiabetic Agents: Reaction or Interaction- A Case Report

Abstract

Background: Type 2 diabetes mellitus is a condition that comprises presence of insulin resistance. Management involves combination of dietary and lifestyle modifications, with deployment of medications as well. Injectable and oral drugs are available for treatment of type 2 diabetes unlike type 1 diabetes that is majorly managed with the use of insulin, which is administered as an injection. The medications act through different mechanisms to increase insulin sensitivity and combat hyperglycaemia. A number of patients with type 2 diabetes mellitus use an average of 2 oral glucose lowering agents for glycaemic control. Virtually all drugs known for treatment of medical conditions generally have individual side effects and there are documented interactions between combinations of some medications. However, most times, oral glucose lowering agents used in managing patients with type 2 diabetes are well tolerated when combined in appropriate manner.

Case Report: We report a case of an unexpected dermatologic reaction in a middle-aged man with type 2 diabetes mellitus following introduction of an additional glucose lowering agent (dipeptidyl peptidase-4- inhibitor) to the oral regimen already being used by the patient. The skin lesions resolved after the withdrawal of the new agent introduced.

Conclusions and Recommendations: The index case has shown that in the process of clinical optimization of patients, there could be unexpected reactions with introduction of new medication. Hence, clinicians should pay attention to the impact of medications on patients as part of holistic management.