Hypoglycemia mimics stroke

Hypoglycemia
can masquerade as stroke in elderly patients, particularly when it progresses to the point where
brain function is impaired, said M.S. Kuhne, M.D., and associates at St. Claraspital in Basel,
Switzerland.

They reported the case of a 90-year-old women with a recent history of falling who was found
lying on the floor of her home. On arrival at the hospital, the woman was confused, had difficulty
speaking, and showed paresis paresis /pa·re·sis/ (pah-re´sis) slight or incomplete paralysis.

general paresis paralytic dementia; a form of neurosyphilis in which chronic

meningoencephalitis causes gradual loss of cortical of her left arm with absent reflexes. Cranial
CT results were normal, but the woman had a low plasma glucose level that resolved, along with
all symptoms, after she received an infusion of glucose solution. A PET scan revealed a
pancreatic insulinoma. The patient refused surgery but responded well to monthly administration
of long-acting octreotide (Lancet 2004;364:2152).

Insulinomas often produce neurologic signs and symptoms such as confusion, coma, convulsion
convulsion, sudden, violent, involuntary contraction of the muscles of the body, often
accompanied by loss of consciousness. It is not known what causes the abnormal impulses from
the brain that result in convulsive seizures, since the disturbance may arise in normal , and visual
disturbances; paralyses--such as the one in this patient--and paresthesias are less common. The
correct diagnosis can be confirmed by a 72-hour fast, which will decrease the patient's plasma
glucose level and reproduce the neuroglycopenic symptoms.

low blood sugar, coma, hypoglycemic agents Hypoglycemic

drug glibenclamide because of effective, low prices are
widely used in clinical treatment of type 2 diabetes, but
serious side effects that cause low blood sugar coma.
Hypoglycemic coma is a common life-threatening
emergency door Health disease, its clinical
manifestations complex, more performance for the
palpitations, sweating, hunger, dizziness, irritability
and then a coma. early detection, early treatment and
intensive care is especially important for the prognosis
of patients. In this paper, our hospital October 17, 2009
 1 out- patients taking glibenclamide treatment were
caused by low blood sugar coma case analysis aimed at
improving the understanding of this disease.

1 Clinical data

Patients, male, 65 years old, history of diabetes. On October 17, 2009 when the clinic accompanied by
palpitations, sweating, hunger, dizziness, irritability and then a coma. Because of the amount of patients with
conventional treatment before taking glibenclamide, To be considered for the oral hypoglycemic agents,
hypoglycemic coma, hospitalized after 1.5 h the onset of observation, not by head CT revealed high density
lesions, checking blood glucose below 1.6 mmol / L, normal electrolytes, urine sugar and ketone bodies were
negative.

2 Treatment and outcome

Diagnosis 50% immediately after the intravenous injection of glucose solution 50 ~ 100 mL, pushing drugs in
patients after 15 ~ 30 mL clear, 15 min after the Q & A to the point, can be self-limbs, every 1 2 h monitoring
of blood glucose, and continue to give 5 % ~ 10% glucose solution by continuous intravenous infusion 24 ~ 48
h, for the prevention of recurrent disease, when blood sugar is less than 4.5 mmol / L again 50% glucose
solution intravenously 40 mL. after 3 fasting blood glucose stabilized at 5.0 ~ 10.7 mmol / L after discharge,
length of stay 3 d.

3 Discussion

Glyburide is a second generation sulfonylurea drugs, the role of fast and strong, and efficacy can be
maintained 10 ~ 15 h, the main side effects are low blood sugar, especially prevalent in the liver, kidney
dysfunction and elderly patients, and may stop repeated episodes of low blood sugar after treatment, severe
cases can lead to conventional doses of low blood sugar, or even coma [1]. diabetes mellitus is diabetic
hypoglycemic coma during treatment in patients with acute severe complicated one, the incidence of acute,
rapid onset If you could rescue the prognosis is good, if not timely detection and treatment will lead to serious
consequences, even life-threatening. If you take positive and effective treatment and care measures, the
prognosis is good. If the first patient, who was not asked in detail about the incidence, ignore the emergence
of low blood sugar, often misdiagnosed as stroke, especially in the longer history of diabetes, the elderly, the
central nervous system dysfunction, similar to the performance of patients with acute stroke [2]. because of
low blood sugar caused by brain damage is reversible, unknown causes coma patients should be routinely
Jicha glucose, and then consider the CT examination, early diagnosis, early treatment, in order to facilitate
recovery.

Links to free paper download

Diabetes is a chronic lifelong metabolic disease, drug therapy to patients with life. Therefore, patients with
diabetes during treatment should prevent the occurrence of hypoglycemic coma. For outpatient diabetes
Education in diabetes knowledge should be strengthened, and told the patients and hypoglycemia and family
self-help measures, and guide the patients regular exercise, proper diet and rational drug therapy, patients
with diabetes to reduce the incidence of hypoglycemic coma and mortality [3]. of taking glibenclamide caused
a high degree of unconscious patients should guard against hypoglycemia, improve the diagnostic rate, seek
time, an active treatment.
What are the performance of low blood sugar?
Sweating; brain halo; rapid heartbeat; eyes take the Golden Flower; trembling; hunger;
weakness; foot numb; slurred speech; irritability; personality changes; disorientation; seizures;
coma
Hypoglycemia how to do?
â‘ 1-2 tablets of sugar or fructose
â‘¡ snacks: 1-2 slices of bread or biscuits 5-6 blocks
â‘¢ half a glass of juice or sugary drinks
â‘£ rice, flour, noodles in a small bowl
The general relief of symptoms within 15 minutes, not to the hospital for treatment should
alleviate the
How to deal with low blood sugar coma?
â‘ if possible, measure blood sugar
â‘¡ there is awareness of the patient can drink syrup
â‘¢ unconscious patients, relatives and friends in the oral mucosa of patients, smear honey on the
gums
â‘£ At the same time to get in touch with the doctor
How to prevent low blood sugar?
â‘ time eating patterns of life
â‘¡ can not arbitrarily increase the amount of drugs
â‘¢ Each dose of insulin should be carefully checked
â‘£ constant exercise
⑤ blood sugar often
â‘¥ carry candy to spare
Reduce the causes of low blood glucose sympathetic activity or central nervous system
dysfunction symptoms.
ANATOMY AND PHYSIOLOGY:

Every cell in the human body needs energy in order to function. The body’s primary energy
source is glucose, a simple sugar resulting from the digestion of foods containing carbohydrates
(sugars and starches). Glucose from the digested food circulates in the blood as a ready energy
source for any cells that need it. Insulin is a hormone or chemical produced by cells in the
pancreas, an organ located behind the stomach. Insulin bonds to a receptor site on the outside of
cell and acts like a key to open a doorway into the cell through which glucose can enter. Some of
the glucose can be converted to concentrated energy sources like glycogen or fatty acids and
saved for later use. When there is not enough insulin produced or when the doorway no longer
recognizes the insulin key, glucose stays in the blood rather entering the cells.
Pathophysiology