Presentation
The present study is aimed at measuring the determinants and predictors of hypoglycaemia among diabetes patients. [endocrine-abstracts.org]
Methods: A retrospective chart review of the UMass Diabetes clinic database was conducted, and included Diabetic adults on insulin who presented to the clinic in September 2013. [shmabstracts.com]
These symptoms, however, if present, last only a few minutes. [diabetesincontrol.com]
The clinical presentation often closely mimics genuine clinical conditions and patients often show concern about their condition and are keen for investigation and interventions. [clinchem.aaccjnls.org]
In other words, the epinephrine warns the patient that hypoglycemia is present and signals the liver to release glucose to reverse it. [en.wikipedia.org]
Entire Body System
-
Fatigue
They include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, tingling or loss of feeling in the hands and feet (diabetic neuropathy), sores that do not heal well, and weight loss. [icdlist.com]
Progressive symptoms may appear, such as dry or flushed skin, fatigue, abdominal pain, nausea and vomiting, difficulty breathing, fruity odor on breath, and confusion. [chrisdudley.org]
Mild hypoglycemia—for example, blood glucose concentrations less than 55 mg per 100 ml (3 mmol/l)—causes hunger, fatigue, tremour, rapid pulse, and anxiety. [britannica.com]
A fall in blood glucose causes symptoms such as hunger, sweating, shakiness, fatigue, weakness, and inability to think clearly, whereas severe hypoglycemia causes symptoms such as confusion, seizures, and coma. [msdmanuals.com]
Hypoglycemia symptoms can include: Shakiness Nervousness or anxiety Sweating, chills, or clamminess Irritability or impatience Dizziness and difficulty concentrating Hunger or nausea Blurred vision Weakness or fatigue Anger, stubbornness, or sadness For [cdc.gov]
-
Euthyroid
He was biochemically euthyroid. Discussion Hypoglycemia is a common complication of insulin therapy in patients with DM, and is a barrier to the achievement of glycemic control. [clinchem.aaccjnls.org]
These values were interpreted as discordant for a diagnosis of either primary hypothyroidism or the sick euthyroid syndrome (decreased thyroid function as a result of a non-thyroidal illness), but possibly consistent with secondary hypothyroidism. [patientcareonline.com]
Cardiovascular
-
Orthostatic Hypotension
Patients with disabling orthostatic hypotension may be treated with salt tablets, support stockings, or fludrocortisone. [emedicine.medscape.com]
-
Mitral Valve Prolapse
His other medical history included mitral valve prolapse, hypertension, and dyslipidemia. [clinchem.aaccjnls.org]
Musculoskeletal
-
Joint Dislocation
HU may result in many serious forms of morbidity including seizure, coma, fractures and joint dislocation and cardiac arrhythmias, and is occasionally fatal. [wjgnet.com]
Neurologic
-
Headache
The percentage of participants who have experienced hypoglycaemia who know the following symptoms (sweatiness, shivering, hunger, weakness, palpitations, anxiety, confusion, visual disruption, light-headedness, convulsion, headache, inability to concentrate [endocrine-abstracts.org]
Symptoms Early warning signs and symptoms Early signs and symptoms of diabetic hypoglycemia include: Shakiness Dizziness Sweating Hunger Irritability or moodiness Anxiety or nervousness Headache Nighttime symptoms Diabetic hypoglycemia can also occur [mayoclinic.org]
Symptoms of Hypoglycemia Symptoms of hypoglycemia include the following: Sweating Rapid pulse Shakiness, dizziness, weakness Decreased coordination Difficulty concentrating Blurred vision Headache Trouble performing routine tasks Note: Symptoms can vary [visionaware.org]
Symptoms include: Shaking, sweating, rapid heartbeat Change in vision Hunger Headache Sudden moodiness As the term implies, low blood sugar, or hypoglycemia, occurs when your brain and body are not getting enough sugar. [dtc.ucsf.edu]
The survey included the following symptoms: anxiety, confusion, blurred vision, dizziness, difficulty in speaking, drowsiness, hunger, headache, inability to concentrate, nausea, sweating, pounding heart, tiredness, tingling lips, trembling, warmth and [bmcendocrdisord.biomedcentral.com]
-
Behavior Problem
problems than those who do not have HU until latter[61,62]. [wjgnet.com]
Workup
The appropriate workup and management of recurrent hypoglycemia is discussed in each case. [patientcareonline.com]
Workup Approach Considerations Search for a source of infection. [emedicine.medscape.com]
• Some patients have symptoms but normal blood glucoses; they need no further workup, in spite of their insistence. 20. [slideshare.net]
Treatment
Previous studies have examined whether intensive treatment of high blood glucose levels could decrease the risk of these events. Hypoglycemia can occur as a result of intensive treatment of T2D. [medivizor.com]
In addition, other factors such as female gender, lower body-mass index, type 1 Diabetes, hypertension, and use of insulin alone as treatment modality, are associated with higher frequency of hypoglycemia. [shmabstracts.com]
Severe or frequent hypoglycemia requires modification of treatment regimens, including higher treatment goals. [unboundmedicine.com]
Evidence Intensive DM treatment is associated with a greater risk of hypoglycemia. [elsevier.es]
Prognosis
Hypoglycemia The prognosis of hypoglycemia depends on the cause, severity, and duration. The prognosis is excellent if identified and treated early. If left untreated, hypoglycemia leads to seizures or unconsciousness. [chrisdudley.org]
The prognosis for a person with this health condition is estimated to be a life expectancy of 10 years less than a person without diabetes. [medicinenet.com]
Because of this patient’s poor prognosis, she did not undergo imaging studies to further delineate her pituitary status. [patientcareonline.com]
"Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview". Stroke. 32 (10): 2426–32. doi:10.1161/hs1001.096194. PMID 11588337. a b Umpierrez, Guillermo E.; Pasquel, Francisco J. (2017). [en.wikipedia.org]
Etiology
Undetectable C-peptide concentrations during 3 separate episodes of hypoglycemia excluded endogenous hyperinsulinism, such as caused by insulinoma, as the etiology of recurrent hypoglycemia ( 3 ). [clinchem.aaccjnls.org]
Glucagon Tolerance Test The glucagon tolerance test serves as a supplemental study to aid in determining the etiology of hypoglycemia. [ncbi.nlm.nih.gov]
Etiology and Pathophysiology Loss of hormonal counterregulatory mechanism in glucose metabolism Too little food (skipping or delaying meals), decreased CHO intake Too much insulin or oral hypoglycemic agent (improper dose, timing, or erratic absorption [unboundmedicine.com]
Abstract In patients with hypoglycemia, the etiologic diagnosis depends on an interpretation of the response of the blood sugar to various provocative tests, usually including the administration of glucose, tolbutamide, L-leucine, and a prolonged fast [annals.org]
References: [1] Etiology Clinical features Symptoms of hypoglycemia normally present at approx. 50 mg/dL (2.8 mmol/L) ; however, this threshold is variable. [amboss.com]
Epidemiology
ALERT Hypoglycemia unawareness Major risk factor for severe hypoglycemic reactions Most commonly found in patients with long-standing T1DM and children age Epidemiology Incidence From the ACCORD study, the annual incidence of hypoglycemia was the following [unboundmedicine.com]
The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study. BMJ 2010; 340: b4909. 32. Nordin C. [diabetesincontrol.com]
Epidemiologic evidences suggest that unless effective preventive measures are implemented the global prevalence will continue to rise [ 2 ]. [jdmdonline.biomedcentral.com]
The DCCT Research Group, Epidemiology of severe hypoglycemia in the Diabetes Control and Complications Trial. Am J Med. 1991;90450- 459Google ScholarCrossref 23. [jamanetwork.com]
However, it continues to be a neglected complication with very limited epidemiological data in our country. [ijem.in]
Pathophysiology
DEVELOPMENT: After reviewing the pathophysiology of hypoglycemia in diabetic patients we will review the role of hypoglycemia in three clinical situations: the hypoglycemia-associated autonomic failure, the brain effects of hypoglycemia in children and [ncbi.nlm.nih.gov]
Hypoglycemia in type 2 diabetes: pathophysiology, frequency, and effects of different treatment modalities. Diabetes Care 2005;28:2948-61. Kjekshus J, Gilpin E, Cali G et al. Diabetic patients and beta-blockers after acute myocardial infarction. [ebmconsult.com]
Etiology and Pathophysiology Loss of hormonal counterregulatory mechanism in glucose metabolism Too little food (skipping or delaying meals), decreased CHO intake Too much insulin or oral hypoglycemic agent (improper dose, timing, or erratic absorption [unboundmedicine.com]
This is video 1 of 2 on diabetic ketoacidosis (pathophysiology and signs of diabetic ketoacidosis / DKA): 0:08 DKA stats 0:47 DKA - cellular anatomy 1:00 mitochondria 1:48 beta-oxidation 2:30 insulin function 3:08 pyruvate 3:19 diabetes mellitus type [youtube.com]
Google Scholar Zammitt NN, Frier BM: Hypoglycemia in type 2 diabetes: pathophysiology, frequency, and effects of different treatment modalities. [jdmdonline.biomedcentral.com]
Prevention
Prevention To help prevent diabetic hypoglycemia: Don't skip or delay meals or snacks. If you take insulin or oral diabetes medication, be consistent about the amount you eat and the timing of your meals and snacks. Monitor your blood sugar. [mayoclinic.org]
The prevention of hypoglycemia requires some principles consideration. [jdmdonline.biomedcentral.com]
PREVENTION AND MANAGEMENT OF HU Prevention of HU Prevention of HU is an important part of modern day intensive diabetes therapy. To prevent HU, the goal is the complete avoidance of hypoglycemia, which is very difficult to achieve[105]. [wjgnet.com]
Harrison Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes [63] A.A. Howard, J.H. Arnsten, M.N. [elsevier.es]
Management of hypoglycemia caused by insulin treatment Management includes the following steps: Restoration of normal plasma glucose levels Prevention of relapse in the short term Prevention of recurrent episodes in the long term. [diabetesincontrol.com]