What should be done if a patient experiences repeat episodes of hypoglycemia after a sulfonylurea overdose?

In cases of sulfonylurea overdose, the body’s insulin release can be significantly overstimulated, leading to prolonged hypoglycemia. Octreotide, a synthetic analogue of somatostatin, is beneficial in this scenario because it can inhibit insulin secretion, helping to stabilize blood glucose levels when patients experience repeated episodes of hypoglycemia.

Switching to insulin therapy would not be appropriate in this context, as the issue arises from excessive endogenous insulin drive caused by the sulfonylurea. Administering more glucagon might provide a temporary increase in glucose levels but could be ineffective if the underlying problem of continued insulin secretion remains. Increasing carbohydrate intake would help in managing hypoglycemia acutely, but it does not address the cause of recurrent hypoglycemia related to sulfonylurea's action on insulin.

By continuing octreotide therapy, you can decrease the effect of the sulfonylurea and help manage the patient more effectively, ultimately reducing the frequency of hypoglycemic episodes. This makes it a suitable choice in the management of repeated hypoglycemia following a sulfonylurea overdose.