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Plasma glucose alone does not predict neurologic dysfunction in hypoglycemic nondiabetic subjects
I Osorio1, B M Arafah, C Mayor
1Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.
Annals of Emergency Medicine
|February 26, 1999
Summary
Plasma glucose concentration alone does not predict neurologic dysfunction during hypoglycemia in nondiabetic individuals. Subtle inattention may be the only manifestation, challenging emergency medicine literature findings.
Area of Science:
- Neuroscience
- Endocrinology
Background:
- Hypoglycemia can cause neurological dysfunction.
- The relationship between plasma glucose levels and neuroglycopenia is not fully understood.
Purpose of the Study:
- To evaluate plasma glucose concentration as a sole predictor of neurologic dysfunction.
- To assess neurologic function and electroencephalographic (EEG) findings during induced hypoglycemia in nondiabetic subjects.
Main Methods:
- 17 nondiabetic subjects underwent insulin-induced hypoglycemia.
- Neurologic function and EEG were assessed using bedside clinical tools before and during hypoglycemia.
Main Results:
- Hypoglycemia (mean nadir 30 mg/dL) minimally affected attention and memory in some subjects.
- No significant correlation was found between neuroglycopenia manifestations, nadir glucose, or hypoglycemia duration.
- Sympathetic stimulation was observed in all subjects.
Conclusions:
- Neurologic dysfunction in hypoglycemia can be subtle or absent, even at low glucose levels.
- Plasma glucose concentration alone is insufficient to predict neurologic deficits.
- Neuroglycopenia expression is multifactorially determined.
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