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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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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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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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Diabetic Ketoacidosis ll: Pathophysiology01:22

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Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
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Hyperosmolar Hyperglycemic State01:21

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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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Diabetic Ketoacidosis l: Introduction01:25

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DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic...
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Hypoglycemia associated with oleander toxicity in a dog.

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Summary

Oleander poisoning in dogs can cause dangerous cardiac issues and hypoglycemia. This case highlights a dog with oleander toxicosis, presenting with both classical symptoms and low blood sugar, leading to a full recovery with supportive care.

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Area of Science:

  • Veterinary Toxicology
  • Cardiology
  • Endocrinology

Background:

  • Oleander (Nerium oleander) poisoning is a well-known veterinary emergency, typically causing cardiac arrhythmias, hyperkalemia, and gastrointestinal distress.
  • Experimental studies suggest oleander extracts possess hypoglycemic properties, but this effect has not been documented in canine oleander toxicosis.

Observation:

  • A 7-year-old female Maltese presented with vomiting, cardiac arrhythmia, and mild hyperkalemia after ingesting oleander leaves.
  • Serum analysis confirmed oleander toxicosis with a digoxin level of 0.7 ng/mL (0.9 nmol/L) 24 hours post-ingestion.
  • The dog also exhibited significant hypoglycemia, a finding not previously reported in canine oleander poisoning.

Findings:

  • Confirmed oleander toxicosis in a dog presenting with classical clinical signs and unexpected hypoglycemia.
  • Successful treatment with aggressive supportive care resulted in complete recovery within 48 hours.
  • The observed hypoglycemia supports experimental findings on the potential blood sugar-lowering effects of oleander.

Implications:

  • This case expands the known clinical presentation of oleander toxicosis in dogs to include hypoglycemia.
  • Highlights the importance of monitoring blood glucose levels in dogs with suspected oleander poisoning.
  • Further research into the hypoglycemic mechanism of oleander in canines is warranted.