A Rare Case of Hypoglycemic Unawareness in a Patent With Chronic Congestve Heart Failure
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Abstract
Hypoglycemia and hypoglycemic unawareness is usually a complication of tight glycemic control in insulin-dependent diabetes mellitus. To our knowledge, this is the first case report of hypoglycemic unawareness subsequent to cardiac failure induced hypoglycemia of prolonged duration. Through this case report, we aimed to highlight that hypoglycemia should be suspected as a cause of decreased level of consciousness in patients suffering from recurrent congestive cardiac failure , as it can be easily overlooked and the condition can easily be reversed by simply administering adequate glucose.
[1] Grimaldi A, Bosquet F, Davidoff P, Digy JP, Sachon , Landault C, et al. Unawareness of hypoglycemia by insulin-dependent diabetc mellitus. Hormone and Metabolic Research. 1990; 22(2):90-5. [DOI:10.1055/s-2007-1004858] [PMID]
[2] Davis MR, Shamoon H. Defcient counterregulatory hormone responses during hypoglycemia in a patent with insulinoma. The Journal of Clinical Endocrinology & Metabolism. 1991; 72(4):788- 92. [DOI:10.1210/jcem-72-4-788] [PMID]
[3] Goldfen A, Moore R, Zileli S, Havens Ll, Boling L, Thorn GW. Plasma epinephrine and norepinephrine levels during insulin-induced hypoglycemia in man. The Journal of Clinical Endocrinology & Metabolism. 1961; 21(3):296-304. [DOI:10.1210/jcem-21-3-296] [PMID]
[4] Mellinkoff ShM, Tumulty PA. Hepatc hypoglycemia- Its occurrence in congestve heart failure. The New England Journal of Medicine. 1952; 247:745-50. [DOI:10.1056/NEJM195211132472001] [PMID]
[5] Cryer P. Glucose homeostasis and hypoglycemia. In: Melmed Sh, Polonsky K, Polonsky R, editors. Williams Textbook of Endocrinology. 11th ed. Philadelphia: Saunders; 2007.
[6] Vignesh JP, Mohan V. Hypoglycaemia unawareness. The Journal of the Associaton of Physicians of India. 2004; 52:727-32. [PMID]
[7] Hepburn DA, Patrick AW, Eadington DW, Ewing DJ, Frier BM. Unawareness of hypoglycaemia in insulin-treated diabetc patents: Prevalence and relatonship to autonomic neuropathy. Diabetc Medicine. 1990; 7(8):711-7. [DOI:10.1111/j.1464-5491.1990. tb01475.x] [PMID]
[8] Simpson IA, Appel NM, Hokari M, Oki J, Holman GD, Maher F, et al. Blood-brain barrier glucose transporter: Effects of hypo-and hyperglycemia revisited. Journal of Neurochemistry. 1999; 72(1):238-47. [DOI:10.1046/j.1471-4159.1999.0720238.x]
[2] Davis MR, Shamoon H. Defcient counterregulatory hormone responses during hypoglycemia in a patent with insulinoma. The Journal of Clinical Endocrinology & Metabolism. 1991; 72(4):788- 92. [DOI:10.1210/jcem-72-4-788] [PMID]
[3] Goldfen A, Moore R, Zileli S, Havens Ll, Boling L, Thorn GW. Plasma epinephrine and norepinephrine levels during insulin-induced hypoglycemia in man. The Journal of Clinical Endocrinology & Metabolism. 1961; 21(3):296-304. [DOI:10.1210/jcem-21-3-296] [PMID]
[4] Mellinkoff ShM, Tumulty PA. Hepatc hypoglycemia- Its occurrence in congestve heart failure. The New England Journal of Medicine. 1952; 247:745-50. [DOI:10.1056/NEJM195211132472001] [PMID]
[5] Cryer P. Glucose homeostasis and hypoglycemia. In: Melmed Sh, Polonsky K, Polonsky R, editors. Williams Textbook of Endocrinology. 11th ed. Philadelphia: Saunders; 2007.
[6] Vignesh JP, Mohan V. Hypoglycaemia unawareness. The Journal of the Associaton of Physicians of India. 2004; 52:727-32. [PMID]
[7] Hepburn DA, Patrick AW, Eadington DW, Ewing DJ, Frier BM. Unawareness of hypoglycaemia in insulin-treated diabetc patents: Prevalence and relatonship to autonomic neuropathy. Diabetc Medicine. 1990; 7(8):711-7. [DOI:10.1111/j.1464-5491.1990. tb01475.x] [PMID]
[8] Simpson IA, Appel NM, Hokari M, Oki J, Holman GD, Maher F, et al. Blood-brain barrier glucose transporter: Effects of hypo-and hyperglycemia revisited. Journal of Neurochemistry. 1999; 72(1):238-47. [DOI:10.1046/j.1471-4159.1999.0720238.x]
| Files | ||
| Issue | Vol 4 No 1 (2019): Winter | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v4i1.1303 | |
| Keywords | ||
| Hypoglycaemia Hypoglycemic unawareness Congestive heart failure | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Yaseen Y, Shah P, Mir I, Amreen S. A Rare Case of Hypoglycemic Unawareness in a Patent With Chronic Congestve Heart Failure. CRCP. 2019;4(1):20-22.
