A 69-year-old male with known case of diabetes mellitus and hypertension was admitted with wet gangrene of right greater toe. He received cilostazol 100mg twice a day for 3 days. During this period, there was a marked elevation of blood sugar requiring higher dosage of insulin. Upon withholding the suspected drug there was a marked fall in blood glucose levels indicating a positive dechallenge. Cilostazol might have loss of diabetic control by favouring intestinal glucose absorption through increased cAMP levels and GLUT2 expression necessitating management with higher dosage of insulin.
Key words: Cilostazol, Wet gangrene, Hyperglycemia, Diabetes mellitus.