Urticaria Due to Adverse Drug Reaction in Diabetes - A Case Presentation

Type 2 diabetes mellitus (T2DM) is a chronic condition caused by the inability of pancreas to produce enough insulin. Insulin lowers the blood glucose and enables it to enter the cells. Urticaria also known as hives is a result of skin reaction when certain body cells release histamine. They are itchy and can appear in any part of the body. Metformin is the first line of treatment for type 2 diabetes mellitus for controlling high blood sugar by decreasing glucose production by the liver and by increasing insulin sensitivity of body tissues. India is at the top of the world with highest number of people with diabetes mellitus (31.7 million). WHO has predicted that by 2030 T2DM may affect up to 79.4 million individuals in India.1Diabetes mellitus is a group of metabolic disorder characterized by increased glucose productionand decreased glucose utilization and the complications arising from this disease are major causes of death worldwide. Cells of the body cannot metabolize carbohydrate due to relative or complete lack of insulin, and so the body breaks its own protein, fat and glycogen resulting in hyperglycemia.2,3 T2DM earlier referred to as non-insulin dependent diabetes or adult onset diabetes, accounts for 90 - 95 % of all diabetes.4 Metformin is an oral agent and is considered as insulin sensitizer because it helps in lowering insulin levels, reduces hepatic glucose production, improves peripheral glucose utilization, and helps in uptake and utilization of gut glucose.5Urticaria is caused by dermal oedema, secondary to temporary increase in capillary permeability resulting from increased release of histamine from the mast cells situated around the capillaries. Urticaria present for more than 6 weeks is considered to be acute and chronic.6