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Related Concept Videos

Hypoglycemia01:26

Hypoglycemia

34
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...
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Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

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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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Hyperglycemia01:29

Hyperglycemia

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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...
35
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

53
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...
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Hyperosmolar Hyperglycemic State01:21

Hyperosmolar Hyperglycemic State

28
Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
28
Diabetic Neuropathy01:22

Diabetic Neuropathy

99
DefinitionDiabetic neuropathy is nerve damage caused by long-standing diabetes mellitus. It results directly from prolonged high blood sugar levels.PathophysiologyThe pathophysiology of diabetic neuropathy involves both metabolic and vascular disturbances triggered by chronic hyperglycemia.Metabolic injury: Elevated glucose levels activate the polyol pathway within nerve cells, leading to the accumulation of sorbitol and fructose. This increases oxidative stress, disrupts normal nerve...
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Hippocampal Insulin Microinjection and In vivo Microdialysis During Spatial Memory Testing
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Hypoglycaemic haemiparesis.

Othman Kirresh1, Achmed Kamara, Samad Samadian

  • 1Department of Medicine, St Georges Hospital, London, UK.

BMJ Case Reports
|October 17, 2013
PubMed
Summary
This summary is machine-generated.

Hypoglycaemic haemiparesis, a stroke mimic, can be misdiagnosed in the emergency department. Prompt glucose normalization can resolve symptoms, but may unmask hypoactive delirium in elderly diabetic patients.

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Area of Science:

  • Neurology
  • Endocrinology
  • Emergency Medicine

Background:

  • Hypoglycaemic haemiparesis (HH) is an uncommon neurological presentation.
  • It frequently mimics stroke, leading to potential misdiagnosis in emergency settings.
  • The underlying mechanism of HH remains incompletely understood.

Observation:

  • A case of an elderly diabetic woman with recurrent hypoglycaemia presented with right-sided hemiparesis.
  • Initial stroke imaging (CT/MRI) did not correlate with her neurological deficits.
  • Neurological deficits resolved upon achieving normoglycaemia via dextrose infusion.

Findings:

  • The patient's weakness resolved with glucose normalization.
  • Post-resolution, increased somnolence was noted.
  • Extensive investigations led to a unifying diagnosis of HH complicated by hypoactive delirium.

Implications:

  • Highlights the importance of considering HH in diabetic patients presenting with stroke-like symptoms.
  • Emphasizes the need for prompt blood glucose assessment and management in emergency departments.
  • Suggests that HH may unmask or trigger delirium, necessitating comprehensive patient assessment.