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Nondiabetic hypoglycemia

P Shobha, Sherly Mathen, Joison Abraham
OBJECTIVE: The objective of the study is to estimate the level of glycosylated hemoglobin (HbA1c) for a safe fetal outcome and to estimate the relation between this level and various adverse fetal outcomes. Materials and. METHODOLOGY: Primigravidas who are diagnosed as not having gestational diabetes mellitus as per the glucose challenge test done at 24 weeks with a cutoff value up to 140 mg/dl are followed up at 30-34 weeks for the estimation of HbA1c in the blood and further till the time of delivery and postnatal period for the fetal outcomes...
July 2016: Journal of Family Medicine and Primary Care
Juvva Gowtham Kumar, K P P Abhilash, Rama Prakasha Saya, Neeha Tadipaneni, J Maheedhar Bose
BACKGROUND: Hypoglycemia is one among the leading causes for Emergency Department (ED) visits and is the most common and easily preventable endocrine emergency. This study is aimed at assessing the incidence and elucidating the underlying causes of hypoglycemia. MATERIALS AND METHODS: A retrospective, observational study which included patients registering in ED with a finger prick blood glucose ≤60 mg/dl at the time of arrival. All patients aged above 15 years with the above inclusion criteria during the period of August 2010 to July 2013 were selected...
January 2017: Indian Journal of Endocrinology and Metabolism
Elaine Chow, Alan Bernjak, Emma Walkinshaw, Alexandra Lubina-Solomon, Jenny Freeman, Ian A Macdonald, Paul J Sheridan, Simon R Heller
Hypoglycemia is associated with increased cardiovascular mortality in trials of intensive therapy in type 2 diabetes (T2DM). We previously observed an increase in arrhythmias during spontaneous prolonged hypoglycemia in T2DM patients. Our aim was to examine changes in cardiac autonomic function and repolarization during sustained experimental hypoglycemia.Twelve adults with T2DM and eleven age, BMI-matched nondiabetic controls underwent paired hyperinsulinemic clamps separated by 4 weeks. Glucose was maintained at euglycemia (6...
January 30, 2017: Diabetes
Victor C Kok, Ping-Hsueh Lee
Hypoglycemia due to underlying terminal illness in nondiabetic end-of-life patients receiving palliative care has not been fully studied. For example, we do not have adequate information on the frequency of spontaneous hypoglycemia in patients as occurs during the different stages of palliative care. Depending on the case-mix nature of the palliative care ward, at least 2% of palliative care patients may develop hypoglycemia near the end of life when the remaining life expectancy counts down in days. As many as 25%-60% of these patients will neither have autonomic response nor have neuroglycopenic symptoms during a hypoglycemic episode...
2016: Palliative Care
Jordan Masse, Christopher Alan Giuliano, Sara Brown, Renee Alexander Paxton
PURPOSE: The purpose of this study was to examine the association between long-acting insulin and hypoglycemia in nondiabetic surgical intensive care patients. METHODS: This single-center, retrospective cohort study evaluated glycemic control in nondiabetic critically ill surgical patients receiving long-acting insulin plus sliding scale versus those receiving sliding scale alone. Patients were matched based on sliding scale order and type of surgery. The primary outcome was the proportion of patients who experienced hypoglycemia (glucose values <70 mg/dL)...
November 7, 2016: Journal of Intensive Care Medicine
Michael R Rickels, Amy J Pelekis, Eileen Markmann, Cornelia Dalton-Bakes, Stephanie M Kong, Karen L Teff, Ali Naji
CONTEXT: Islet transplantation has been shown to improve glucose counterregulation and hypoglycemia symptom recognition in patients with type 1 diabetes (T1D) complicated by severe hypoglycemia episodes and symptom unawareness, but long-term data are lacking. OBJECTIVE: To assess the long-term durability of glucose counterregulation and hypoglycemia symptom responses 18 months after intrahepatic islet transplantation, and associated measures of glycemic control during a 24 month follow-up period...
August 29, 2016: Journal of Clinical Endocrinology and Metabolism
Avital Adler, Michal-Yackobovitz Gavan, Riva Tauman, Moshe Phillip, Shlomit Shalitin
BACKGROUND: Sleep has been shown to impact glucose regulation, and may be altered in persons with type 1 diabetes (T1D). OBJECTIVE: To assess sleep characteristics in T1D patients and the possible association between sleep disturbances and diabetes-related variables. SUBJECTS AND METHODS: In a cross-sectional study in 154 young patients with T1D and 154 age-range-matched nondiabetic controls subjective sleep characteristics were assessed using validated questionnaires: Sleep Disturbance Scale for Children (SDSC), Adolescent Sleep-Wake Scale (ASWS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS)...
August 3, 2016: Pediatric Diabetes
Monica Nannipieri, Anna Belligoli, Daniela Guarino, Luca Busetto, Diego Moriconi, Roberto Fabris, Andrea Mari, Simona Baldi, Marco Anselmino, Mirto Foletto, Roberto Vettor, Ele Ferrannini
CONTEXT: Postprandial hypoglycemia (PPHG) is a recognized complication of Roux-en-Y gastric bypass (RYGB) surgery. Data on PPHG after laparoscopic sleeve gastrectomy (LSG) are scant. OBJECTIVE: The objective of the study was to identify preoperative predictors of PPHG in subjects spontaneously self-reporting PPHG after RYGB or LSG. Patients, Setting, and Intervention: Nondiabetic patients spontaneously self-reporting symptoms/signs of PPHG (PPHG group, 21 RYGB and 11 LSG) were compared in a case-control design with subjects who never experienced spontaneous or oral glucose tolerance test (OGTT)-induced hypoglycemia over 24 months after surgery (No-PPHG group, 13 RYGB and 40 LSG)...
October 2016: Journal of Clinical Endocrinology and Metabolism
Clare J Lee, G Craig Wood, Mariana Lazo, Todd T Brown, Jeanne M Clark, Christopher Still, Peter Benotti
OBJECTIVE: The epidemiology of post-gastric bypass surgery hypoglycemia (PGBH) is incompletely understood. This study aimed to evaluate the risk of PGBH among nondiabetic patients and associated factors. METHODS: A cohort study of nondiabetic patients who underwent Roux-en-Y gastric bypass (RYGB) was conducted. PGBH was defined by any postoperative record of glucose < 60 mg/dL, diagnosis of hypoglycemia, or any medication use for treatment of PGBH. Kaplan-Meier analysis was used to describe PGBH occurrence, log-rank tests, and Cox regression to examine associated factors...
June 2016: Obesity
Guntram Schernthaner, Marie Helene Schernthaner-Reiter, Gerit-Holger Schernthaner
During the last decade, the armamentarium for glucose-lowering drugs has increased enormously by the development of DPP-4 inhibitors, GLP-1 receptor agonists and SGLT2 inhibitors, allowing individualization of antidiabetic therapy for patients with type 2 diabetes (T2DM). Some combinations can now be used without an increased risk for severe hypoglycemia and weight gain. Following a request of the US Food and Drug Administration, many large cardiovascular (CV) outcome studies have been performed in patients with longstanding disease and established CV disease...
June 2016: Clinical Therapeutics
Delphine Vezzosi, Antoine Bennet, Solange Grunenwald, Philippe Caron
Whereas hypoglycaemia is uncommon in nondiabetic patients, it is a frequent reason for consultation. Hypoglycaemia is confirmed when criteria of Whipple's triad are fulfilled. If a venous sample cannot be collected when hypoglycemia occurs spontaneously, a 72-hour-fast test should be performed firstly to affirm the reality of hypoglycaemia and secondly to make the etiological diagnosis. Before carrying out this long and expensive test, the obvious causes of hypoglycaemia must be ruled out: iatrogenic, severe prolonged undernutrition, liver or renal deficiency, adrenal insufficiency, IGFII or pro-IGFII secreting tumours…At the time of hypoglycemia, plasma insulin≥3mUI/L, C-peptide≥0...
June 2016: La Presse Médicale
Thomas O Mundinger, Qi Mei, Alan K Foulis, Corinne L Fligner, Rebecca L Hull, Gerald J Taborsky
In humans, the glucagon response to moderate-to-marked insulin-induced hypoglycemia (IIH) is largely mediated by the autonomic nervous system. Because this glucagon response is impaired early in type 1 diabetes, we sought to determine if these patients, like animal models of autoimmune diabetes, have an early and severe loss of islet sympathetic nerves. We also tested whether this nerve loss is a permanent feature of type 1 diabetes, is islet-selective, and is not seen in type 2 diabetes. To do so, we quantified pancreatic islet and exocrine sympathetic nerve fiber area from autopsy samples of patients with type 1 or 2 diabetes and control subjects without diabetes...
August 2016: Diabetes
Vivi Flou Hjorth Jensen, Anne-Marie Mølck, Annette Heydenreich, Karin Juul Jensen, Line Olrik Bertelsen, Lene Alifrangis, Lene Andersen, Henrik Søeborg, Melissa Chapman, Jens Lykkesfeldt, Ingrid Brück Bøgh
New insulin analogues with a longer duration of action and a flatter pharmacodynamic profile are developed to improve convenience and safety for diabetic patients. During the nonclinical development of such analogues, safety studies must be conducted in nondiabetic rats, which consequently are rendered chronically hypoglycemic. A rat comparator model using human insulin would be valuable, as it would enable differentiation between effects related to either persistent insulin-induced hypoglycemia (IIH) or a new analogue per se...
January 2016: Journal of Toxicologic Pathology
Jean Chen, Amy Diesburg-Stanwood, Geza Bodor, Neda Rasouli
Hemoglobin A1c (A1c) is used frequently to diagnose and treat diabetes mellitus. Therefore, it is important be aware of factors that may interfere with the accuracy of A1c measurements. This is a case of a rare hemoglobin variant that falsely elevated a nondiabetic patient's A1c level and led to a misdiagnosis of diabetes. A 67-year-old male presented to endocrine clinic for further management after he was diagnosed with diabetes based on an elevated A1c of 10.7%, which is approximately equivalent to an average blood glucose of 260 mg/dL...
January 2016: Journal of Investigative Medicine High Impact Case Reports
Marilyn J Hammer, Gail D'Eramo Melkus, M Tish Knobf, Corey Casper, Jason Fletcher, Charles M Cleland
BACKGROUND: Patients undergoing hematopoietic cell transplantation (HCT) for hematological malignancies experience a number of challenges during treatment. There is growing evidence that malglycemia (hyperglycemia, hypoglycemia, and/or increased glycemic variability) contributes to HCT-related complications, even in patients without preexisting diabetes. The purpose of this pilot study was to investigate factors influencing glycemic status and associated infection occurrences in nondiabetic autologous HCT recipients...
May 2016: Biological Research for Nursing
Michael A Mancano
The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Mancano at ISMP, 200 Lakeside Drive, Suite 200, Horsham, PA 19044 (phone: 215-707-4936; e-mail: Your report will be published anonymously unless otherwise requested...
September 2015: Hospital Pharmacy
Ranjita Santra Dhali, Prithwijit Banerjee, Santanu Munshi, Patralekha Ray Chaudhuri
Sertraline is a selective serotonin reuptake inhibitor. It has been shown to blunt postprandial hyperglycemia in rats and to potentiate the hypoglycemic effects of sulfonylurea agents in humans. Here, we report a case of a 33-year-old nondiabetic patient with no history of glucose intolerance, who experienced multiple episodes of hypoglycemia that resolved after discontinuation of the drug. Healthcare professionals should consider sertraline among the possible causes of hypoglycemia occurring in patients receiving antidepressants...
September 2015: Indian Journal of Pharmacology
Jacques M Himpens, Ramon Vilallonga, Guy-Bernard Cadière, Guido Leman
BACKGROUND: In the technique used in our department, Roux-en-Y gastric bypass (RYGB) anatomically only differs from the mini- or omega loop gastric bypass (OLGB) by the incorporation of an isolated alimentary limb, called the Roux limb. The metabolic consequences of the incorporation of a Roux limb are unknown. OBJECTIVES: To evaluate differences in glucose and insulin dynamics between RYGB and OLGB in normoglycemic patients, by submitting them to a glucose challenge after stabilization of their weight...
July 2016: Surgical Endoscopy
Chin-Li Lu, Pei-Chun Hsu, Hsiu-Nien Shen, Ya-Hui Chang, Hua-Fen Chen, Chung-Yi Li
To compare the incidence and relative risk of falls between adults with and without diabetes, and to prospectively assess the role of history of severe hypoglycemia in the putative relationship between diabetes and falls in younger and older people, respectively.The National Health Insurance Research Database in Taiwan was used in this cohort study. Diabetic cases (with and without history of severe hypoglycemia) and nondiabetic people were followed from 2000 to 2009. There were 31,049 people enrolled in each of the 3 groups...
August 2015: Medicine (Baltimore)
Nicolas R Bolo, Gail Musen, Donald C Simonson, Lisa D Nickerson, Veronica L Flores, Tamar Siracusa, Brandon Hager, In Kyoon Lyoo, Perry F Renshaw, Alan M Jacobson
UNLABELLED: Human brain networks mediating interoceptive, behavioral, and cognitive aspects of glycemic control are not well studied. Using group independent component analysis with dual-regression approach of functional magnetic resonance imaging data, we examined the functional connectivity changes of large-scale resting state networks during sequential euglycemic-hypoglycemic clamp studies in patients with type 1 diabetes and nondiabetic controls and how these changes during hypoglycemia were related to symptoms of hypoglycemia awareness and to concurrent glycosylated hemoglobin (HbA1c) levels...
August 5, 2015: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
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