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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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Diabetes Mellitus: Overview and Type I Subtype01:22

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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
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Insulin: Dosing Regimen and Adverse Effects01:16

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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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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...
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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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Diabetes: Symptoms, Diagnosis, and Complications01:15

Diabetes: Symptoms, Diagnosis, and Complications

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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Author Spotlight: Investigating the Blood Glucose Homeostasis in Murine Brain Using a Cost-Effective Hyperglycemic And Hypoglycemic Clamp Technique
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Insulinoma Causing Prolonged Hypoglycaemic Coma.

Prabhat Kumar1, Ajay Chauhan2, Juhi Dixit3

  • 1Senior Resident, Department of Medicine, PGIMER and Dr RML Hospital , New Delhi, India .

Journal of Clinical and Diagnostic Research : JCDR
|September 23, 2016
PubMed
Summary
This summary is machine-generated.

Insulinoma, a rare pancreatic tumor causing low blood sugar, can rarely lead to fatal hypoglycaemic coma. This case highlights a fatal outcome in an elderly patient with insulinoma.

Keywords:
C-peptideNesidioblastosisWhipple’s triad

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Area of Science:

  • Endocrinology
  • Oncology
  • Pathology

Background:

  • Insulinoma is a rare pancreatic endocrine tumor with an incidence of 4 cases per million per year.
  • Fasting hypoglycemia is the most common symptom, often leading to delayed diagnosis due to varied presentations.
  • Surgical resection typically offers a good prognosis once diagnosed.

Observation:

  • This report details a rare case of severe hypoglycemia leading to coma and death.
  • The patient was an elderly man diagnosed with insulinoma.
  • The severe hypoglycemia proved fatal despite the generally good prognosis associated with insulinoma.

Findings:

  • Recurrent hypoglycemia is a hallmark of insulinoma.
  • Delayed diagnosis is common due to the diverse clinical manifestations of insulinoma.
  • Fatal hypoglycemic coma is an exceptionally rare complication of insulinoma.

Implications:

  • This case underscores the potential severity of insulinoma, even in elderly patients.
  • It highlights the importance of timely diagnosis and management of pancreatic endocrine tumors.
  • Understanding rare fatal outcomes is crucial for refining treatment strategies and patient counseling for insulinoma.