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Related Concept Videos

Hypoglycemia01:26

Hypoglycemia

30
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...
25
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

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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...
1.0K
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

26
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...
26
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

1.3K
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
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Hyperinsulinaemic hypoglycaemia.

V B Arya1, Z Mohammed1, O Blankenstein2

  • 1London Centre for Paediatric Endocrinology and Metabolism, Great Ormond Street Hospital for Children NHS Trust and The Institute of Child Health, University College London, London, UK.

Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|February 22, 2014
PubMed
Summary
This summary is machine-generated.

Hyperinsulinaemic hypoglycaemia (HH) involves unregulated insulin secretion, leading to dangerously low blood glucose. Genetic defects and insulinomas are key causes, with varying presentations in newborns and adults.

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Area of Science:

  • Endocrinology
  • Molecular Genetics
  • Pediatrics

Background:

  • Insulin secretion from pancreatic beta-cells normally maintains blood glucose homeostasis (3.5-5.5 mmol/l).
  • Hyperinsulinaemic hypoglycaemia (HH) is characterized by persistent, unregulated insulin secretion despite low glucose levels.
  • Recent genetic advances illuminate the molecular underpinnings of HH.

Purpose of the Study:

  • To review the molecular mechanisms driving hyperinsulinaemic hypoglycaemia (HH) in pediatric and adult populations.
  • To outline the clinical presentation and diagnostic approaches for various forms of HH.
  • To discuss current and emerging treatment strategies for HH.

Main Methods:

  • Literature review of genetic defects and molecular pathways implicated in HH.
  • Analysis of clinical data regarding the presentation and diagnosis of HH.
  • Synthesis of information on therapeutic interventions for different HH etiologies.

Main Results:

  • Genetic defects in key regulatory genes are linked to severe forms of HH, particularly in newborns.
  • Insulinomas are the most frequent cause of HH in adults.
  • Understanding molecular mechanisms aids in diagnosis and treatment selection.

Conclusions:

  • HH results from dysregulated insulin secretion due to genetic mutations or tumors.
  • Early diagnosis and targeted treatment are crucial for managing HH in all age groups.
  • Continued research into molecular mechanisms promises improved therapeutic outcomes for HH.