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Related Concept Videos

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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Hypoglycemia01:26

Hypoglycemia

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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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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...
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Hyperosmolar Hyperglycemic State01:21

Hyperosmolar Hyperglycemic State

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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...
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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

Glucose Homeostasis: Pancreatic Islets and Insulin Secretion

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
Insulin and C-peptide are...
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Hormones Regulating Blood Glucose01:16

Hormones Regulating Blood Glucose

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Insulin is released by beta cells of the pancreas when blood glucose levels are high. It facilitates glucose absorption and utilization in insulin-dependent cells with insulin receptors on their plasma membranes. Insulin promotes glucose uptake by increasing the number of glucose transport proteins in the cell membrane, allowing glucose to enter the cell. As a result, glucose utilization and ATP production are enhanced.
In addition to accelerating glucose uptake and utilization, insulin has...
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Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
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Nonislet cell tumor hypoglycemia.

Johnson Thomas1, Salini C Kumar

  • 1Department of Endocrinology, Diabetes & Metabolism, Nassau University Medical Center, East Meadow, NY 11554, USA.

Case Reports in Endocrinology
|November 7, 2013
PubMed
Summary
This summary is machine-generated.

Nonislet cell tumor hypoglycemia (NICTH) is a rare condition caused by tumors. Steroid treatment effectively resolved hypoglycemia in a patient with esophageal cancer by addressing "big" IGF II.

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In Vivo Model for Testing Effect of Hypoxia on Tumor Metastasis
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In Vivo Model for Testing Effect of Hypoxia on Tumor Metastasis
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In Vivo Model for Testing Effect of Hypoxia on Tumor Metastasis

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Area of Science:

  • Endocrinology
  • Oncology
  • Metabolic Disorders

Background:

  • Nonislet cell tumor hypoglycemia (NICTH) is a rare endocrine disorder characterized by tumor-induced hypoglycemia.
  • It is often associated with large mesenchymal tumors, particularly those in the gastrointestinal tract.
  • Pathophysiology involves excessive glucose utilization driven by tumor-secreted factors.

Purpose of the Study:

  • To discuss a rare case of NICTH secondary to esophageal cancer.
  • To review the pathophysiology of NICTH.
  • To highlight recent advances in managing NICTH.

Main Methods:

  • Case presentation of a patient with poorly differentiated squamous cell carcinoma of the esophagus.
  • Diagnostic workup for hypoglycemia, including assessment of insulin-like growth factor II (IGF II).
  • Therapeutic intervention with corticosteroids.

Main Results:

  • The patient presented with persistent hypoglycemia despite nutritional support.
  • Standard hypoglycemia workup was negative, and IGF II levels were normal.
  • Treatment with steroids rapidly resolved hypoglycemia, suggesting "big" IGF II mediation.
  • Hypoglycemia unawareness resolved after achieving euglycemia.

Conclusions:

  • NICTH can be caused by non-mesenchymal tumors, such as esophageal squamous cell carcinoma.
  • Steroid therapy is an effective treatment for NICTH, likely by modulating IGF II activity.
  • Early recognition and management are crucial for patients with NICTH.