Hyperglycemic, Nonketotic Coma Following Administration of Dilantin (Diphenylhydantoin)

Two critically ill patients are described in whom the intravenous administration of Dilantin produced marked alterations in plasma glucose and blood pressure. The first patient, a nondiabetic with chronic lung disease received a total of 1.8 gm. Dilantin over a 48-hr, period for status epilepticus. Plasma glucose increased from normal to 1,200 mg./100 ml. and his seizures became focal in nature. The second patient, a mildly diabetic male, experienced renal shut-down and multiple arrythmias after a myocardial infarct. Three hours after a single intravenous injection of 200 mg. Dilantin, plasma glucose rose from 400 mg. to 1,260 mg./100 ml. and proved relatively resistant to insulin. Intravenous administration of 25 mg. Dilantin per kg. in four dogs promptly induced marked hyperglycemia and hypotension.