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Related Concept Videos

Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are typically...
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...

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Related Experiment Video

Updated: Jun 12, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Severe hypoglycaemia associated with ingesting counterfeit medication.

Santosh K Chaubey1, Kunwarjit S Sangla, Emershia N Suthaharan

  • 1Department of Diabetes and Endocrinology, The Townsville Hospital, Townsville, QLD, Australia. drchaubeysk@rediffmail.com

The Medical Journal of Australia
|June 23, 2010
PubMed
Summary
This summary is machine-generated.

Counterfeit Cialis, imported across borders, caused severe hypoglycemia in a 54-year-old Australian man. This case highlights the dangers of unapproved medications and the need for vigilance against counterfeit drugs.

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Area of Science:

  • Pharmacology
  • Toxicology
  • Public Health

Background:

  • Cross-border importation of prescription medications is prevalent, with many unapproved by the Australian Therapeutic Goods Administration.
  • Counterfeit prescription drugs, including those for weight loss, anabolic steroids, and sexual performance enhancement, pose a significant public health risk.

Observation:

  • A 54-year-old male presented with severe hypoglycemia.
  • Laboratory confirmation revealed the cause to be counterfeit Cialis (tadalafil).
  • This represents the first reported Australian case of hypoglycemia linked to imported counterfeit medication.

Findings:

  • Imported counterfeit Cialis was definitively identified as the etiological agent for severe hypoglycemia.
  • The counterfeit drug was not approved by Australian regulatory authorities.

Implications:

  • Medical practitioners should consider counterfeit medications as a potential cause of unexplained severe hypoglycemia and other adverse health events.
  • Increased awareness and regulatory scrutiny are necessary to combat the circulation of dangerous counterfeit pharmaceuticals.