A female patient was hospitalised recently for diabetic ketoacidosis, characterised by lethargy, polyuria and polydipsia. The patient had apparently defaulted follow-up with her doctor and stopped taking her anti-diabetic medications when she started taking a Jamu product, Kenis Pil® about 3 years ago. The product was labelled to contain herbal ingredients and claimed to cure symptoms of diabetes.
Findings of the analytical testing
The product was sent to the Centre for Analytical Science of HSA for testing. On analysis, it was found to be adulterated with glibenclamide. Based on a recommended daily intake of 10 tablets 3 times daily, the patient would be consuming 0.9 mg of glibenclamide daily.
Discussion
The patient was self-medicating with a Jamu medicine adulterated with glibenclamide; her diabetic condition was not controlled thus resulting in diabetic ketoacidosis. Unsupervised use of glibenclamide poses a high risk to patients. Doses have to be adjusted in elderly patients and those with moderate to severe renal and liver impairments.
Healthcare professionals are reminded to report adverse reaction suspected to be associated with complementary medicine as post-marketing spontaneous reporting remains the main tool available to monitor the safety of these products.
