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PubMed2001

Hypoglycemic disorders.

Hypoglycemia occurs as an epiphenomenon in many serious diseases and further investigation may be unnecessary. In other, often seemingly healthy individuals, it is responsible for their presenting symptoms. In them preliminary diagnosis depends on demonstrating a low blood glucose concentration during spontaneous symptoms by ambulatory self-collection of capillary blood and its analysis for glucose in the laboratory. Subsequent investigation requires appropriate plasma hormone analysis on blood collected while the patient is hypoglycemic.

Blood Glucose↗
PubMed2001

[Hypoglycemic hemiplegia: a report of three cases].

Hemiplegia is a rare complication accompanied with hypoglycemia. We reported three cases of hypoglycemic hemiplegia (HH). Case 1: A 74-year-old female had medication for diabetes mellitus (DM). She had right hemiplegia and aphasia. Case 2: A 72-year-old male had DM, and was admitted to our hospital having loss of consciousness and right hemiplegia. Case 3: An 82-year-old female suffered from consciousness disturbance with tetraplegia, and had left hemiparesis later. She had no DM, but suffered from iatrogenic hypoglycemia. The brain CT of these three cases showed atrophy, and MRI demonstrated multiple infarction. The angiography of case 1 showed the stenosis of bilateral internal carotid artery and the origin of the left vertebral artery. The angiography of case 2 showed severe stenosis of the left internal carotid artery. The cases above had hypoglycemia at admission. The value of the case 1 was 48 mg/dl, case 2 was 35 mg/dl and case 3 was 38 mg/dl. But these symptoms of the three cases disappeared rapidly after glucose infusion. The literature regarding HH was reviewed, and the pathogenesis was discussed. We emphasize the importance of checking blood sugar levels for the emerging patients with hemiplegia, because it is difficult to discriminate by clinical history or neurological findings.

Aged↗
PubMedDate not supplied

[Semi-automatic determination of blood lactate during hypoglycemic treatment with biguanides].

Blood lactate levels were determined by Lactate Analyzer 640 Kontron in 67 adult insulin-independent diabetics during hypoglycemic treatment with usual therapeutical doses of phenformin. In 5 cases were found lactate values above 2 mmol/l and, in consideration of accompanying conditions prone to lactic acidosis, the drug was discontinued. However, the mean value of blood lactate in diabetics treated with phenformin was not significantly different from that found in a group of insulin-treated diabetics. The semiautomatic determination of blood lactate is proposed as a rapid screening of possible candidates for lactic acidosis during biguanide treatment.

Autoanalysis↗
PubMed2002

Transient hypoglycemic hemiparesis.

Transient hypoglycemic hemiparesis is a rare but important presentation of hypoglycemia that is frequently misdiagnosed as stroke. This is a case of an 18-year-old black female with type 1 diabetes who presented to the emergency department with recurrent acute episodes of hemiparesis that resolved completely after dextrose infusion. It is the intention of the authors to increase awareness of this disorder which, if misdiagnosed, could result in permanent neurological damage. Current theories on the etiology of this disorder are discussed.

Adolescent↗
PubMed1992

Potentiation of hypoglycemic response of glibenclamide by piroxicam in rats and humans.

Influence of piroxicam (PX) on glibenclamide (GL) induced hypoglycemia has been studied in rats, healthy human volunteers and diabetics. GL per se has significantly reduced blood sugar levels in rats and in humans. PX per se has significantly reduced BSLs, in diabetics, while having no significant influence on blood sugar level in rats and healthy human volunteers. Prior administration of PX has potentiated the hypoglycemic effect of GL in rats, healthy human volunteers and diabetics. GL, PX + GL administration have also significantly influenced the glucose tolerance test (GTT) in healthy human volunteers.

Animals↗
PubMed2004

Solitary fibrous tumor of the liver with presenting symptoms of hypoglycemic coma.

We report a patient with solitary fibrous tumor of the liver, a rare fibrous neoplasm which to our knowledge has been reported in only 21 patients in the English literature. Most frequently, solitary fibrous tumors arise in the thoracic cavity, particularly in the pleura. Hypoglycemia has rarely been associated with these mesenchymal tumors. The presentation of this patient with hypoglycemic coma without preceding symptomatology, to our knowledge, has never been reported.

Aged↗
PubMed2004

Transient hypoglycemic abducens palsy.

Since 1928, among the thousands of patients treated for insulinoma, only 32 cases with peripheral neuropathy have been reported. None of these described an affection of the cranial nerves. We present a 56 old woman, who suffered from chronic hyperinsulinism due to an insulinoma. For ten years, the patient has developed progressively marked hypoglycemic attacks of up to 20 mg/dl. Recently we have observed the development of a paresis of the right abducens nerve lasting for 6 weeks.

Abducens Nerve Diseases↗
PubMedDate not supplied

Malignant solitary fibrous tumor of the thigh accompanied by hypoglycemic coma. A case report.

A case of malignant solitary fibrous tumor of the thigh with liver and lung metastasis, suspicious of non-islet cell tumor-associated hypoglycemia is reported. The patient, a 76-year-old woman, was initially aware of an increasing soft tissue tumor in the left thigh, and episodes of hypoglycemia gradually developed. These frequent episodes ceased after resection of the thigh tumor, which was diagnosed as malignant solitary fibrous tumor. Considering that (i) the primary lesion developed in a rare site, (ii) the tumor was a malignant variant (accompanied by liver and lung metastasis), and (iii) the lesion was accompanied by typical hypoglycemic episodes, this case seemed to be extremely rare.

Aged↗
PubMed1992

Capillary recruitment for preservation of cerebral glucose influx in hypoglycemic, preterm newborns: evidence for a glucose sensor?

Changes in cerebral blood volume (CBV) were investigated by means of near-infrared spectroscopy in 18 preterm newborns during treatment with intravenous bolus glucose. All newborns were breathing spontaneously, and their postnatal age was 2 hours. Blood glucose concentration ranged between 0.3 and 2.2 mmol/L. Cerebral blood volume began to decrease shortly after the glucose infusion was terminated, and steady state was obtained after approximately 3 minutes. The decrease in CBV averaged 0.15 mL/100 g (range 0.02 to 0.40 mL/100 g). Thereafter, CBV remained constant. Individual reductions in CBV were inversely related to the pretreatment concentration of glucose, whereas there was no relation between changes in CBV and alterations in blood gas values or in mean arterial blood pressure. It is suggested that previously unperfused capillaries are recruited to maintain the glucose transport into neurons of hypoglycemic, preterm newborns. The rapidity whereby vessels adjust to alterations in glucose levels indicates the existence of a cerebral glucose sensor.

Blood Glucose↗
PubMed2003

Hypoglycemic potential of tablet Metformin 500 mg (Glucophage & Metphage): a pharmacological end point evaluation.

Quantitative determination of pharmacological response or clinical end point study is essential for successful evaluation of clinical pharmacology and Bioavailability/ Bioequivalence issues. Stride has been made for proper selection of a quality drug product from the various available therapeutic, which is the prime responsibility of Health care provider and specially pharmacist. Study was conducted in respect to investigate the Pharmacodynamics response, differences and individual variation of oral, Metphage (Metformin 500 mg tablet) as a test formulation manufactured by Efroze Chemical Industries (Pvt.) Ltd. and Glucophage (Metformin 500 mg tablet) as a reference formulation manufactured by Merck Marker. Blood glucose levels/hypoglycemic effect produced by both formulation were studied under cross over trial with respect to placebo/control treatment and result were discussed accordingly. There were no hypoglycemic episodes requiring medical intervention and/or pharmacologic therapy so the patients can easily manage it. Results of the study clearly suggest that formulation manufactured by Efroze Chemical Industries (Pvt.) Ltd. is near to the standard formulation and produced comparable results. No significant differences in pharmacodynamics was observed, however, minor differences might relate with inter individual variation in human volunteers and in different formulation as well as different pharmaceutical unit. Although this data assure the ultimate quality of Metformin 500 mg tablet manufactured by Efroze Chemical Industries (Pvt.) Ltd. but every Generic equivalent should be studied for assurance of safety and efficacy because life of patient is a matter of concern. Such type of study would provide better evaluation of the performance of a drug from a dosage form.

Journal Article↗
PubMed1989

Hypoglycemic effect of Allium sativum on oral glucose tolerance test in rabbits.

The effect of crude garlic and its two organic extracts on blood glucose levels of rabbits have been studied. It was found that the petroleum ether extract and crude garlic juice had some hypoglycemic effect on the induced hyperglycemia in the experimental animals, whereas no effect was observed on the group fed on ethanol extract.

Journal Article↗
PubMedDate not supplied

[Hypoglycemic convulsions and hypopituitarism].

A case of hypopituitarism in a female, aged 6 months, whose first symptom consisted of hypoglycemic convulsions is reported. Making use of TRH we confirm the hypothalamic origin of pituitary failure. Substitution therapy controlled the episodes of convulsions and normalized the growth rate of the child.

Adrenocorticotropic Hormone↗
PubMed1992

Toxic hypoglycemic syndrome--Jamaica, 1989-1991.

In January and February 1991, the health officer in the parish of St. Ann, Jamaica, received reports of eight persons with toxic hypoglycemic syndrome (THS), an illness associated with consumption of unripe ackee fruit and, possibly, renta yam; two cases were fatal. On July 25, the Jamaican Ministry of Health (JMH) contacted CDC for assistance in investigating the continued occurrence of THS; the collaborative JMH and CDC epidemiologic investigation focused on characterizing the epidemiology of THS in Jamaica and assessing the role of ackee fruit, renta yams, and other factors.

Adolescent↗
PubMed1977

Clinical significance of circulating C-peptide in diabetes mellitus and hypoglycemic disorders.

Proinsulin is converted to insulin and C-peptide in the pancreatic in the pancreatic beta cells: the latter two peptides are secreted in equimolar concentrations. Thus, measurements of serum C-peptide provide a means of assessing pancreatic beta cell function in addition to that of insulin. This technique has proved particularly useful in insulin treated diabetic patients in whom the development of circulating insulin antibodies interferes with the radioimmunoassay of the hormone. The C-peptide assay has also been used to facilitate the diagnosis of various hypoglycemic conditions, including islet cell tumors and factitious injection of insulin. The extraction of C-peptide in the urine reflects average serum values over a period of time and urine C-peptide measurements are especially useful in children or individuals in whom repeated blood sampling is difficult.

Adenoma, Islet Cell↗
PubMedDate not supplied

[Mode of action of hypoglycemic sulfanilamides].

Sulfonylureas act as hypoglycemic agents by stimulating insulin secretion and improving insulin sensibility by a post-receptor mechanism. Their long term results mainly depend on extra-pancreatic mechanisms. Moreover they indirectly decrease triglyceridemia. Glipizide and gliclazide enhance fibrinolysis. Gliclazide also inhibits platelet aggregation and adhesion. The best indication of sulfonylureas is non insulin dependent diabetes with normal weight.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

[The hypoglycemic reactions in diabetic patients in the emergency room. Which patients are going to be hospitalized?].

In one year, a retrospective study in a casualty department identified 67 hypoglycemic episodes occurring to adult diabetic patients: 40 insulin-treated, 20 oral antidiabetic-treated, 7 with unrecorded treatment. All the oral antidiabetic-treated patients were on glibenclamide and the mean dose was 6.5 mg/day: 35.7% of the patients admitted to the medical ward were discharged without antidiabetic drug prescription, suggesting that previous treatment had been unnecessary. Thirty one of the subjects had to be admitted to the medical ward: they were significantly older, mainly on oral antidiabetic treatment and their glucose blood levels were significantly lower than those of the patients treated in the casualty department and sent home. The subjects were admitted mainly because of associated disease, late complications of the diabetic status or home care shortage.

Adult↗
PubMed1990

Hypoglycemic coma in anorexia nervosa. Case report and review of the literature.

Clinically significant hypoglycemia is an unusual complication of anorexia nervosa. We describe a 44-year-old woman with a 5-year history of anorexia nervosa who presented with hypoglycemic coma and eventually experienced sudden death. Biochemical studies showed suppressed levels of insulin, C peptide, and proinsulin during hypoglycemia; appropriate elevations of growth hormone and cortisol levels were observed, suggesting that the hypoglycemia was related to severe malnutrition. Nine previously reported cases of severe hypoglycemia in anorexia nervosa are reviewed (six of the patients involved also died). The presence of severe hypoglycemia in anorexia nervosa implies a grave prognosis and mandates aggressive medical and nutritional therapy to improve the chance of survival.

Adult↗
PubMedDate not supplied

[Hypopituitarism in the aged. Report of a case revealed by hypoglycemic coma (author's transl)].

The diagnosis of anterior pituitary insufficiency is difficult in the elderly and frequently made when the patient become comatose. At this age hypoglycemia is rarely the exclusive factor of this coma. The authors report a case revealed by hypoglycemic coma and supported by the lack of stimulation by the releasing factors. None etiology was found. With hormone treatment the patient recovered a normal life.

Aged↗