Glycaemic effect of colestyramine therapy

Abstract

diabetes of 15 years’ duration was referred to a secondary care diabetes clinic due to a rapid deterioration in her glycaemic control. The patient had been diagnosed with idiopathic bile acid malabsorbtion four months previously as part of investigations for chronic anaemia. She was therefore prescribed colestyramine 4g twice daily. Initially, her pharmacist dispensed Questran, and the patient’s glycaemic control was noted to deteriorate, with her HbA1c rising to 8.7% (72mmol/mol) from a stable pre-treatment value of around 7.2% (55mmol/mol); (Figure 1). Her home blood glucose monitoring (HBGM) diary concurred with this finding. She was advised to change to sugar free Questran Light instead. Six weeks prior to her first diabetes clinic appointment, Questran Light was sourced, and this had been dispensed from that time. When she was reviewed in clinic, six weeks after the change in formulation her HbA1c was 5.5% (37mmol/mol), and her blood glucose had reverted to well controlled levels.