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Alcohol-induced Hypoglycemia

Alcohol Induced Hypoglycemia


Presentation

  • We present one such case where chronic alcoholism combined with prolonged fasting lead to such a state and patient ended in a persistent vegetative state.[ncbi.nlm.nih.gov]
  • This essential primer presents compelling evidence on how alcohol abuse is directly related to one-third of all deaths in the United States.[books.google.com]
  • The present case is the first reported in which alcohol-induced hypoglycemia developed following inhalation of alcohol. A six month-old male infant became comatose following sponge bathing with ethyl alcohol.[pediatrics.aappublications.org]
  • If pyruvate is present, the following pathway occurs: pyruvate enter the mitochondrium, pyruvate carboxylase converts it to oxalacetate, mitochondrial malate dehydrogenase converts oxalacetate to malate, malate exit the mitochondrium, cytosolic malate[flipper.diff.org]
  • Focus on the practical guidance you need with the aid of a new, more templated format in which basic science content has been integrated within clinical chapters, and all procedural content has been streamlined for online presentation and paired with[books.google.com]
Hemophilia A
  • Stay up to date with new chapters on Clotting Disorders and Hemophilia, Patient-Centered Care, Health Disparities and Diversity in Emergency Medicine, Cost-Effectiveness Analysis, Antibiotic Recommendations for Empirical Treatment of Selected Infectious[books.google.com]
Hypothermia
  • Discussion In the United States, alcoholic patients who present with a depressed mental status are usually not in a hypoglycemic coma, but instead have other etiologies of coma such as sepsis, shock, hypothermia, trauma, or excessive intoxication.[intjem.springeropen.com]
Respiratory Distress
  • Inside, you’ll find totally updated coverage of vital topics, such as coagulation and apoptosis in certain critical care illnesses, such as acute lung injury and adult respiratory distress syndrome; sepsis and other serious infectious diseases; specific[books.google.com]
Increased Appetite
  • This is in contrast to the increased appetite and weight gain often induced by insulin and sulfonylureas.[bouldermedicalcenter.com]
Dizziness
  • Signs include Hunger Shakiness Dizziness Confusion Difficulty speaking Feeling anxious or weak In people with diabetes, hypoglycemia is often a side effect of diabetes medicines. Eating or drinking something with carbohydrates can help.[icdlist.com]
  • Symptoms of mild hypoglycemia can resemble early pregnancy symptoms, including hunger, nausea, sleepiness, headache, weakness and dizziness.[livestrong.com]
  • The symptoms of hypoglycemia can mimic those of intoxication: dizziness, disorientation and sleepiness.[healthyeating.sfgate.com]
  • Hangovers result in unpleasant physical and mental symptoms including fatigue, headache, dizziness, and vertigo.[thoughtco.com]
  • Blurred vision or changes in vision Dizziness, lightheadedness, or shakiness Fatigue and weakness Fast or pounding heartbeat Sweating more than usual Headache Nausea or hunger Anxiety, Irritability, or confusion How is non-diabetic hypoglycemia diagnosed[drugs.com]
Seizure
  • Another potential second-stage symptom is withdrawal-related seizures.[recoveryranch.com]
  • A patient presenting with hypoglycemia can easily be misdiagnosed as a stroke, seizure, psychosis, drug ingestion, or a traumatic head injury if the blood glucose level is not obtained.[cdemcurriculum.com]
  • Neuroglycopenic Symptoms Neuroglycopenia is the impaired delivery of glucose to the brain, and results in: headache confusion slurred speech seizures coma death These symptoms often result from a gradual decline in blood glucose which does not trigger[sharinginhealth.ca]
  • Recognize the signs and symptoms of hypoglycemia early because untreated hypoglycemia can lead to: Seizure Loss of consciousness Death Hypoglcemia can also contribute to: Falls Injuries Motor vehicle accidents Hypoglycemia unawareness Over time, repeated[mayoclinic.org]
  • Seizures may occur as the glucose falls further. As blood glucose levels fall below 10 mg/dl (0.55 mM), most neurons become electrically silent and nonfunctional, resulting in coma.[allaboutheaven.org]
Tremor
  • The first stage of alcohol withdrawal is marked by tremors. These tremors usually begin eight to 12 hours after the person has stopped consuming alcohol. The tremors can be made worse if the person experiences any kind of agitation.[recoveryranch.com]
  • These include anxiety palpitations tremors sweating These symptoms usually occur when blood glucose levels fall abruptly.[sharinginhealth.ca]
  • ., tachycardia), tremor, and sweating. Mental symptoms include dizziness; a sense of the room spinning (i.e., vertigo); and possible cognitive and mood disturbances, especially depression, anxiety, and irritability.[thoughtco.com]
  • Findings include; anxiety/irritability diaphoresis nausea/vomiting nervousness palpitations/tachycardia tremor CNS dysfunction predominates in most cases of hypoglycemia but a rapid drop in blood glucose will also produce the “hyperepinephrinemic” findings[cdemcurriculum.com]
  • Symptoms and effects of hypoglycemia can include dizziness, fatigue, sleep disorders, headaches, lack of ability to concentrate, depression, anxiety, light-headedness, tremors, cold sweats, heart palpitations, loss of coordination, and upset stomach.[nourishedhealth.com]
Stupor
  • […] of light in the field of vision Automatic behavior, also known as automatism Difficulty speaking, slurred speech Ataxia, incoordination, sometimes mistaken for "drunkenness" Focal or general motor deficit, paralysis, hemiparesis Paresthesia, headache Stupor[allaboutheaven.org]
  • SIGNS-SYMPTOMS-Physical-Exam 1) General : confusion, lethargy 2) HEENT: diplopia 3) CVS : tachycardia 4) Neurologic: tremulousness, weakness, paresthesias, stupor, seizure, or coma 5) Mental status: irritability, inability to concentrate, or short-term[slideshare.net]
Altered Mental Status
  • Obtaining an accurate medical history in a patient with an altered mental status can be difficult.[cdemcurriculum.com]
  • If the patient has altered mental status, is unable to swallow, or does not respond to oral glucose administration within 15 minutes, give an IV bolus of 12.5 to 25 g of glucose (25 to 50 mL of 50 percent dextrose).[slideshare.net]

Workup

  • . • Some patients have symptoms but normal blood glucoses; they need no further workup, in spite of their insistence. 20.[slideshare.net]
Pericardial Effusion
Fasting Hypoglycemia
  • For fasting hypoglycemia, you may have your blood glucose checked every few hours during a fast lasting several days. For reactive hypoglycemia, you might have a test called a mixed-meal tolerance test (MMTT).[hormone.org]
  • The 2 types of non-diabetic hypoglycemia are fasting hypoglycemia and reactive hypoglycemia. Fasting hypoglycemia often happens after the person goes without food for 8 hours or longer.[drugs.com]
  • Fasting Hypoglycemia Fasting hypoglycemia tends to produce neuroglycopenic symptoms and may result from decreased liver production of glucose, ie in patients with liver damage.[sharinginhealth.ca]
  • At levels below 50 mg/dl, the diagnosis is fasting hypoglycemia. What causes Hypoglycemia? Dietary carbohydrates play a central role in the cause, prevention, and treatment of hypoglycemia.[doctormurray.com]
  • They are: 1) from early NIDDM (type II diabetes) or glucose intolerence 2) alimentary hypoglycemia 3) alcohol induced and 4) idiopathic "unknown cause" Alcohol can cause FASTING hypoglycemia when alcoholics who have damaged their liver from years of alcohol[afibbers.org]

Treatment

  • Transplantation 765 65 Treatment of Diabetes in the Hospitalized Patient 1103 66 The Diabetic Foot Strategies for Treatment 1111 BIOLOGY OF THE COMPLICATIONS OF DIABETES 793 67 Vascular Disease of the Lower Extremities 1123 Cameron M Akbari and Frank[books.google.com]
  • With the prevalence of diabetes increasing, health care providers working in acute care settings need to be prepared to recognize alcohol-induced hypoglycemia quickly and respond with appropriate treatment.[ncbi.nlm.nih.gov]
  • Get clear, concise descriptions and evidence-based treatment guidelines for a full range of clinical conditions, ranging from the common to the unusual.[books.google.com]
  • Make the best clinical decisions with an enhanced emphasis on evidence-based practice and expert opinions on treatment strategies. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography.[books.google.com]
  • This thoroughly updated edition includes an introduction to risk assessment and screening and results of recent clinical trials and their implications for treatment and prevention.[books.google.com]

Prognosis

  • The prognosis is good, if the condition is treated in a prompt manner Drug-Induced Hypoglycemia can be prevented in non-diabetic individuals by avoiding drugs intended to reduce blood glucose levels, as well as through proper management of diet and exercise[dovemed.com]
  • Prognosis of alcohol-associated lactic acidosis in critically ill patients: an 8-year study. Sci. Rep. 6, 35368; doi: 10.1038/srep35368 (2016). References 1. Thomas, I.[nature.com]

Etiology

  • The probable etiology of low blood sugar in our patient was alcohol-induced inhibition of gluconeogenesis along with starvation. The prolonged hypoglycemia caused cortical damage simulating ischemic brain damage.[ncbi.nlm.nih.gov]
  • Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • (Etiology) The direct cause of Drug-Induced Hypoglycemia is the unregulated use of one of several types of medications that cause blood sugar levels to drop.[dovemed.com]
  • Occasionally people lose their memory permanently………… A case study of an alcoholic with severe long-term hypoglycemia: - Jain H, et als. 2002 “The probable etiology of low blood sugar in our patient was alcohol-induced inhibition of gluconeogenesis along[allaboutheaven.org]
  • Subsequent Measures After initial stabilization, subsequent management should be directed at searching for the underlying etiology of hypoglycemia and preventing further attacks .[slideshare.net]

Epidemiology

  • Epidemiology Hypoglycemia is common in type 1 diabetes, especially in patients receiving intensive therapy, in whom the risk of severe hypoglycemia is increased more than threefold.[slideshare.net]
Sex distribution
Age distribution

Pathophysiology

  • Patients who use insulin as a part of intensive therapy are at increased risk of hypoglycemia several hours after drinking alcohol. return to top Pathophysiology Glucagon and epinephrine are the most important immediate responders to hypoglycemia.[sharinginhealth.ca]
  • Alcohol-induced hypoglycemia may be only one example of this phenomenon; further research should be done to elucidate how these factors can affect other basic pathophysiologic processes.[intjem.springeropen.com]

Prevention

  • This thoroughly updated edition includes an introduction to risk assessment and screening and results of recent clinical trials and their implications for treatment and prevention.[books.google.com]
  • Endocrine and Reproductive 1099 Surgical Interventions in 1125 Cooccurring Addiction 1137 Cooccurring Addiction 1151 Cooccurring Addiction 1180 Cooccurring Addiction and Attention 1211 Integrating Psychosocial Services 1239 and Rebecca A Payne MD 98 Preventing[books.google.com]
  • Dutas 2.42 Dutas prevents the conversion of testosterone to dihydrotestosterone (DHT) in the body. DHT is involved in the development of benign prostatic hyperplasia (BPH).[sieb96.org]
  • The Lipid Research Clinics Coronary Primary Prevention Trial Results, II: the relationship of reduction in incidence of coronary heart disease to cholesterol lowering. ‎[books.google.es]
  • Preventing hypos after alcohol Alcohol can sometimes trick us.[diabetes.co.uk]

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