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Hyperglycemia

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...

Diabetes Mellitus: Introduction

Diabetes Mellitus: Introduction

Diabetes mellitus consists of chronic metabolic disorders characterized by persistent hyperglycemia. This elevated blood glucose results from defects in insulin secretion, impaired insulin action, or both. Insulin, produced by pancreatic β-cells, is essential for maintaining glucose homeostasis by facilitating cellular glucose uptake for energy or storage. Disruptions in insulin production or function lead to glucose accumulation in the bloodstream, causing the clinical features and long-term...

Diabetes Mellitus: Type 2 and Gestational

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...

Pathophysiology of Diabetes

Pathophysiology of Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility, suggesting a...

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type II Diabetes Mellitus III: Clinical Manifestations and Diagnosis

Type 2 diabetes mellitus develops gradually and is often asymptomatic in early stages.Clinical ManifestationsWhen symptoms appear, they include fatigue, blurred vision, pruritus, delayed wound healing, and recurrent infections, particularly candidal infections. Peripheral neuropathy may present as numbness or tingling in the extremities. Classic hyperglycemia symptoms—polyuria, polydipsia, and polyphagia—are less common. Most patients are overweight and frequently have associated hypertension...

Hypoglycemia and Glucagon

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...

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Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Neonatal hyperglycaemia: a challenging diagnosis.

Sara Noéme Prado¹, Raquel Amaral, Teresa Tomé

¹Pediatric Department, Centro Hospitalar de Cascais, Lisbon, Portugal. saranoeme@gmail.com

BMJ Case Reports

|July 7, 2012

Summary

Transient neonatal diabetes mellitus (NDM) is a rare condition. This case highlights challenges in managing tiny insulin doses for infants with NDM, emphasizing its diagnostic importance.

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Area of Science:

Endocrinology
Genetics
Neonatology

Background:

Neonatal diabetes mellitus (NDM) is a rare genetic disorder affecting 1 in 400,000 to 500,000 live births.
Until recently, understanding of NDM pathogenesis and management has been limited.

Observation:

A 2-day-old female infant presented with severe hyperglycemia (glucose > 400 mg/dl), glycosuria, and ketonuria.
No autoimmune markers were detected, suggesting a non-type 1 diabetes cause.
Insulin therapy was required for 51 days, posing management challenges due to the need for precise, minute insulin dosages.

Findings:

The case illustrates transient NDM, a form of diabetes presenting in the neonatal period.
Difficulties in achieving metabolic control underscore the complexities of managing NDM in infants.
Exclusion of common hyperglycemia causes is crucial for diagnosing NDM.

Implications:

NDM diagnosis has significant clinical, genetic, and therapeutic implications for affected neonates.
Early and accurate diagnosis is vital for appropriate management and long-term outcomes.
This case contributes to the understanding of NDM management strategies.