• Title/Summary/Keyword: hypoglycemia

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The effect of Lantus on glycemic control in children and adolescents with type 1 diabetes mellitus (1형 당뇨병을 가진 소아와 청소년에서 란투스 치료의 혈당 조절에 대한 효과)

  • Rhie, Young Jun;Chae, Hyun Wook;Kim, Ho Seong;Kim, Duk Hee
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.565-569
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    • 2007
  • Purpose : With a duration of action of approximately 24 hours and peakless levels, Lantus is a more physiologic basal insulin analogue compared with NPH. The aim of this study was to compare the glycemic control of Lantus plus Humalog with that of premixed insulin in children and adolescents with type 1 diabetes mellitus. Methods : The subjects consisted of 25 patients with type 1 diabetes mellitus, aged 12-19 years, who changed their insulin regimen from premixed insulin to Lantus plus Humalog. Daily insulin doses, frequency of hypoglycemia, fasting blood glucose, C-peptide concentration and HbA1c before and 6 months after Lantus treatment were compared. 24 hour blood glucose of 11 patients among Lantus treatment group (n=25) and premixed insulin treatment group (n=10) were self-monitored and compared. Results : 6 months after Lantus treatment, the episodes of hypoglycemia were reduced by 50%(15.1 vs. 7.6 events/month), especially nocturnal hypoglycemia by 67%(6.7 vs. 2.5 events/month). HbA1c was reduced from 9.3% to 8.7% after Lantus treatment. Self-monitored blood glucose of Lantus treatment group at postbreakfast 30, 60, 90 and 120 minutes were 171.1, 169.5, 171.0 and 154.1 mg/dL respectively and lower than those of premixed insulin treatment group (259.7, 282.7, 280.0 and 250.9 mg/dL respectively). Conclusion : Compared with premixed insulin, Lantus plus Humalog is more effective in glycemic control and reduction in nocturnal hypoglycemia in children and adolescents with type 1 diabetes mellitus.

Hepatic glycogenosis in a patient with poorly controlled type 1 diabetes mellitus (혈당 조절이 불량한 제1형 당뇨병 환자에서 발생한 간의 당원축적증)

  • Jin, Hye-Young;Kang, Dae-Young;Choi, Jin-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1279-1282
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    • 2009
  • Hepatomegaly and liver dysfunction might develop in patients with diabetes mellitus due to glycogen deposition or nonalcoholic steatohepatitis. We experienced a case of hepatic glycogenosis in a patient with type 1 diabetes mellitus who presented with recurrent hypoglycemia, suggesting impairment of glycogenolysis and gluconeogenesis. A 10-year-old girl with a 4-year history of type 1 diabetes mellitus was admitted because of recurrent hypoglycemia and abdominal pain in the right upper quadrant. She had Cushingoid features and hepatomegaly that extended 6 cm below the right costal margin. Laboratory data and radiologic examination revealed elevated liver enzyme levels due to fatty liver. Periodic acid-Schiff (PAS) staining revealed intense glycogen deposition in the cytoplasm of the hepatocytes and PAS reactivity was lost with diastase treatment. At 2 months after administration of glucagon injection and uncooked cornstarch between meals and at bedtime, the hypoglycemic episodes and liver dysfunction improved. It is important to distinguish hepatic glycogenosis from steatohepatitis, because it is possible to prevent excessive hepatic glycogen storage in hepatic glycogenosis cases by strictly controlling blood glucose level and by glucagon administration. To prevent severe hypoglycemic symptoms accompanied by hepatic glycogenosis, we suggest that uncooked cornstarch, which is effective in maintaining blood glucose level, can also be administered.

A Case of Solitary Fibrous Pleura Tumor Associated with Severe Hypoglycemia: Doege-Potter Syndrome

  • Jang, Jong Geol;Chung, Jin Hong;Hong, Kyung Soo;Ahn, June Hong;Lee, Jae Young;Jo, Jae Ho;Lee, Dong Won;Shin, Kyeong Cheol;Lee, Kwan Ho;Kim, Mi Jin;Lee, Jung Cheul;Lee, Jang Hoon;Lee, Jae Kyo
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.120-124
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    • 2015
  • Solitary fibrous tumor of the pleura (SFTP) is a rare primary intrathoracic tumor that arises from mesenchymal tissue underlying the mesothelial layer of the pleura. It usually has an indolent clinical course. The hypoglycemia that accompanies SFTP was first described by Doege and Potter independently in 1930, hence the eponym Doege-Potter syndrome (DPS). The incidence of DPS is reported to be ~4%. In this report, we present a typical case of DPS that was cured through complete surgical resection.

Changes in Serum Protein Profile, Cholesterol and Blood Glucose during Endotoxic Shock in Buffalo Calves Supplemented with Vitamin E and Selenium

  • Sharma, Neeraj;Singha, S.P.S.;Ahuja, C.S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.2
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    • pp.192-196
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    • 2005
  • A study was conducted to monitor the changes in serum protein profile, cholesterol and blood glucose during endotoxic shock in buffalo calves and also to assess the role of prophylactic supplementation of vitamin E and selenium in alleviating the endotoxic effects. Fifteen male buffalo calves (6-8 months of age) were divided into three groups: Group I (control)-infused with 0.9% saline solution; Group II-infused with E. coli endotoxin at 5${\mu}g/kg$ body weight in normal saline solution; Group III- supplemented prophylactically with 250 mg vitamin E and 7.5 mg selenium by i/m injections at weekly intervals for one month prior to the induction of endotoxic shock. The blood samples were collected at 0, 1, 3, 6, 9, 12, 24, 48 and 72 h after the induction of shock. Endotoxin caused a significant (p<0.05) hypoproteinemia from 3-12 h post infusion in group II but this hypoproteinemia was less pronounced and only from 3-9 h post infusion in vitamin E and selenium supplemented calves. Hypoglycemia was observed in group II from 3-24 h and blood glucose level returned to normal at 72 h. However hypoglycemia was mild in group III and blood glucose returned to normal at 48h. Hypocholesterolaemia and hypoalbuminemia were found in both groups II and III but these changes were less pronounced in group III i.e. vitamin E and Se supplemented calves. Serum electrophoretic protein patterns of group III were quite similar to those of control group but animals of group II had different electrophoretic pattern. It was concluded that the antioxidant effects of vitamin E and Se prevent the liver against oxidative stress during endotoxic shock.

Glucose Variations in the First Day of Life of Newborns under Observational Surveillance (관찰감시를 요하는 저위험신생아의 생후 초기 혈당변이 탐색)

  • Cho, Jung Ae;Son, Kyoung Hee;Eom, Hyun Young;Lim, Seo Hae;Jun, Yong Hoon;Ahn, Young Mee
    • Child Health Nursing Research
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    • v.26 no.2
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    • pp.212-221
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    • 2020
  • Purpose: Nursing protocols for glucose management are well known for both healthy term newborns and high-risk newborns. However, for less risky newborns who are under only observation surveillance, hypoglycemia could be overlooked unless clinical symptoms develop. Methods: A retrospective study was performed to explore factors influencing variations in glucose levels in 91 newborns who did not require any interventions, but were under nursing surveillance, at a level II neonatal intensive care unit. Data were retrieved from electrical medical records on glucose levels, demographic characteristics, and other clinical characteristics of newborns in their first day of life from January 2016 to May 2019. Results: Glucose levels tended to stabilize within the normal range (60~80 mg/dL) as time passed during the first day of life. Cesarean section, multiple gestation, abnormal growth, and later preterm birth were associated with low glucose levels in the first 2 hours of life. Thirty-one newborns experienced a hypoglycemic episode (< 45 mg/dL) during the first 24 hours of life. Conclusion: The findings of this study support the active encouragement of early feeding within 2 hours of birth and urgent adoption of a structural protocol for glucose surveillance in newborns with potential health problems immediately after birth.

Hepatocellular Carcinoma in a Cocker Spaniel Dog with Hypoglycemia (저혈당증을 동반한 코커스파니엘견에서의 간선암종 증례)

  • Kang, Min-Hee;Yoo, Jong-Hyun;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.27 no.2
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    • pp.175-178
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    • 2010
  • A 5-year-old male Cocker spaniel was presented with an abrupt seizure episode. The dog was moderately dehydrated, hypersalivation and loss of consciousness at the presentation. Tentative diagnosis was made through history taking, clinical signs, physical examination, neurologic examination, basic laboratory examinations, radiological examination and cytologic examination. In addition, serum alpha-fetoprotein (AFP) value was measured to diagnose in this case. The serum AFP concentration was marked elevated (1513.5 ng/ml). The patient was suspected as HCC and medical therapy was initiated to control hypoglycemic-associated seizure. However, the dog was euthanized because of the owner's request. It was diagnosed as hepatocellular carcinoma (HCC) based on the histopathologic examination. This case indicates that AFP measurement might be valuable to diagnose HCC in dogs.

Biochemical Nutritional Status of Serum Lipids, Protein, and Blood Glucose in School Children in Bucheon

  • Koo Jae Ok;Kim Soon Ki;Shin Dong Mi
    • Journal of Community Nutrition
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    • v.7 no.1
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    • pp.3-7
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    • 2005
  • This study was conducted to evaluate nutritional status of school children by biochemical assessment method. Subjects were 308 school children from 4th to 6th grade living in Bucheon city. Their blood glucose, total protein, albumin, total cholesterol, and triglyceride (TG) concentrations were determined. Mean blood glucose concentration was 77.56 mg/dl and $81.2\%$ of children had normal blood glucose concentration. The average proportion of hypoglycemia was $18.8\%$ among the three grades and prevalence of hypoglycemia in 4th grade school children was highest ($21.8\%$). Mean serum total protein and albumin levels were 7.14g/dl and 4.35g/dl, respectively, and all the subjects except only one were in normal range of total protein and albumin. Mean serum TG and total cholesterol concentrations were 145.82mg/dl and 94.50mg/dl. Serum TG and total cholesterol levels showed same pattern that the concentrations decreased in proportion to grade. Especially, there was significant difference between grades in serum total cholesterol. Furthermore, $11.7\%$ of 4th, $6.8\%$ of 5th, and $2.8\%$ of 6th grade school children have borderline hypertriglycemia or hypertriglycemia, risk factors of obesity or cardiovascular disease later in life. Taken together, there was conflict phenomenon that undernutrition of hypertriglycemia and overnutrition of hypertriglycemia existed together. Therefore, it is needed to develop discriminating and personalized nutritional feeding, counseling, and education program to cover the children of under- or over- nutritional status.

Diabetes Management and Hypoglycemia in Safety Sensitive Jobs

  • Lee, See-Muah;Koh, David;Chui, Winnie Kl;Sum, Chee-Fang
    • Safety and Health at Work
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    • v.2 no.1
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    • pp.9-16
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    • 2011
  • The majority of people diagnosed with diabetes mellitus are in the working age group in developing countries. The interrelationship of diabetes and work, that is, diabetes affecting work and work affecting diabetes, becomes an important issue for these people. Therapeutic options for the diabetic worker have been developed, and currently include various insulins, insulin sensitizers and secretagogues, incretin mimetics and enhancers, and alpha glucosidase inhibitors. Hypoglycemia and hypoglycaemic unawareness are important and unwanted treatment side effects. The risk they pose with respect to cognitive impairment can have safety implications. The understanding of the therapeutic options in the management of diabetic workers, blood glucose awareness training, and self-monitoring blood glucose will help to mitigate this risk. Employment decisions must also take into account the extent to which the jobs performed by the worker are safety sensitive. A risk assessment matrix, based on the extent to which a job is considered safety sensitive and based on the severity of the hypoglycaemia, may assist in determining one's fitness to work. Support at the workplace, such as a provision of healthy food options and arrangements for affected workers will be helpful for such workers. Arrangements include permission to carry and consume emergency sugar, flexible meal times, selfmonitoring blood glucose when required, storage/disposal facilities for medicine such as insulin and needles, time off for medical appointments, and structured self-help programs.

Influence of Pre-operative Fasting Time on Blood Glucose in Older Patients (수술 전 금식이 노인환자의 혈당에 미치는 영향)

  • Hong, Mi-Suk;Yoon, Hae-Sang
    • Journal of Korean Academy of Nursing
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    • v.41 no.2
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    • pp.157-164
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    • 2011
  • Purpose: This study was performed to identify changes in blood glucose at preoperative fasting time in surgical patients over 60 yr. Methods: Data collection was performed from July, 2008 through July, 2009. Participants consisted of 80 nondiabetic surgical patients. Blood glucose was checked from 3 to 5 times. The 5 times were 2-hr fasting on the pre-operative day (T1, n=80), 8 hr (T2, n=80), 10 hr (T3, n=17), 12 hr (T4, n=34) and 14 hr fasting on the day of the operation (T5, n=29). Results: Of the patients, 27.5% had a blood glucose level of less than 79 mg/dL at T2; 17.6% at T3; 32.4% at T4; and 17.2% at T5. Mean blood glucose levels were 93.8 mg/dL at T1; 88.4 mg/dL at T2; 91.7 mg/dL at T3; 87.4 mg/dL at T4: and 94.1 mg/dL at T5. Blood glucose was the lowest at T2 (p<.001). Conclusion: As 17.6-32.4% of the patients showed the blood glucose level of less than 79 mg/dL at 8-14 hr pre-operative fasting, the authors recommend that surgical patients p>60 yr-of-age be observed for hypoglycemia during pre-operative fasting of more than 10 hr and that surgical patients >60 yr-of-age with risks for hypoglycemia be scheduled for operation within 10 hr preoperative fasting.

A Case of Congenital Intrahepatic Portosystemic Shunt Associated with VSD Detected by Antenatal Sonography and Treated with Four Coil Embolizations and Open Heart Surgery after Birth (산전 초음파로 발견되고 출생 후 4회의 코일 색전술과 심 교정술로 치료된 심실 중격 결손을 동반한 선천성 간내 문맥전신성 단락 1례)

  • Na, Ji-Youn;Kim, Eun-Sun;Kim, Sang-Duk;Kim, Ee-Kyung;Kim, Han-Suk;Choi, Jung-Hwan;Chung, Jeong-Eun;Joung, Jin-Uuk
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.176-182
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    • 2008
  • A congenital portosystemic shunt is a very rare portosystemic vascular anomaly which leads to jaundice, hypoglycemia, hyperammonemia, liver cirrhosis, hepatic coma, and pulmonary hypertension. Anatomically, portosystemic shunts are divided into intra- and extrahepatic shunts. Congenital intrahepatic portosystemic shunts are rare anomalies, and the early diagnosis is important to prevent hepatic encephalopathy and hypoglycemia. We report a case of an infant with symptoms of heart failure due to a congenital intrahepatic portosystemic shunt and a ventricular septal defect (VSD), which were treated successfully with four coil embolizations and open heart surgery for the VSD.