CLINICAL EXAMPLES OF HYPOGLYCEMIC STATES IN THE PRACTICE OF EMERGENCY MEDICINE, WHICH ARE NOT ASSOCIATED WITH DIABETES MELITUS
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i3.14908Keywords:
hypoglycemic conditions, paramedic, pathophysiology of emergency conditions, clinical pathophysiologyAbstract
SUMMARY. Hypoglycemic conditions are quite common in the practice of emergency physicians and paramedics. Some of the reasons of this are diabetes mellitus, then the diagnosis of this condition is not difficult. However, hypoglycemia often occurs in other diseases that are not related with diabetes, which can lead to incorrect diagnosis, especially when one patient has several diseases. Our article provides several examples of non-diabetic hypoglycemia that are not related to diabetes.
The aim – to draw the attention of medical workers to the problem of hypoglycemic conditions, which arise not only on the basis of diabetes mellitus, for the timely provision of targeted medical care.
Material and Methods. Examples are given and an analysis of hypoglycemic states in different pathologies not related with diabetes mellitus.
Results. The article provides examples of hypoglycemic conditions that are not associated with diabetes mellitus. Case 1. Hypoglycemic coma in the oncological patient. Case 2. Hypoglycemia with excessive alcohol consumption. 3. Hypoglycemic coma during of a suicide attempt. The correct diagnosis of the hypolycemic state made it possible to provide medical assistance to these patients in a timely manner.
Conclusions. Medical workers should pay attention to the manifestations of hypoglycemic conditions, which can be observed not only in diabetes mellitus, in order to provide timely specialized medical care.
References
Cryer, P. E., Davis, S. N., Shamoon, H. (2023) Hypoglycemia in Diabetes. Diabetes Care, 26(6), 1902–1912. DOI: 10.2337/diacare.26.6.1902.
Kalra, S., Jit, S., Bajwa, S., Baruah, M. (2013) Hypoglycaemia in anesthesiology practice: Diagnostic, preventive, and management strategies. Saudi Journal of Anaesthesia, 7(4), 447-452. DOI: 10.4103/1658-354X.121082.
Bano, G. (2013). Glucose homeostasis, obesity and diabetes. Best Practice & Research Clinical Obstetrics & Gynaecology Anaesthesia 27(5), 715–726 DOI: 10.1016/j.bpobgyn.2013.02.007.
Alfhili, M.A., Alsughayyir, J., Basudan, A.M., Alsubki, R., Alqahtani, S., Awan, Z.A., Algethami, M.R., Al-Sheikh, Y.A. (2022). Monocyte-Lymphocyte Ratio and Dysglycemia: A Retrospective, Cross-Sectional Study of the Saudi Population Healthcare 10(11), 2289. DOI:10.3390/healthcare10112289.
Philip, E. (2006) Cryer Hypoglycemia in diabetes: pathophysiological mechanisms and diurnal variation. Progress in Brain Research, 153, 361-365 DOI:10.1016/S0079-6123(06)53021-3.
Marks, V., Derrick Teale, J. (1999) Drug-Induced Hypoglycemia. Endocrinology and Metabolism Clinics of North America 28(3), 555-577. DOI:10.1016/S0889-8529(05)70088-8
Koch, C. A., Petersenn, S. (2019) Black swans – Neuroendocrine tumors of rare locations. Reviews in Endocrine and Metabolic Disorders, 19, 111–121 DOI: 10.1007/s11154-018-9473-0
Daughaday, W. H. (2007) Hypoglycemia due to paraneoplastic secretion of insulin-like growth factor-I. The Journal of Clinical Endocrinology & Metabolism, 92(5), 1616. DOI: 10.1210/jc.2007-0378
Dardano, A., Daniele, G., Lupi, R. Napoli, N., Campani, D., Boggi, U., Del Prato, S., Miccoli, R. (2020). Nesidioblastosis and Insulinoma: A Rare Coexistence and a Therapeutic Challenge. Frontiers in Endocrinology, 11(10), 1-6 DOI: 10.3389/fendo.2020.00010
Tuháčková, M., Urbanová, J., Brunerova, L., Pithova, P. (2019) Ethanol and risk of hypoglycemia in patients with type 1 diabetes mellitus: a brief overview for clinical practice. Vnitrni lekarstvi, 65(4), 303-306. DOI: 10.36290/vnl.2019.053
Halushko, O.A. (2022) Hipohlikemichnyi syndrom u medytsyni nevidkladnykh staniv [Hypoglycemic syndrome in emergency medicine]. Medytsyna nevidkladnykh staniv – Emergency medicine, 18(7), 18-17 DOI: 10.22141/2224-0586. 18.7.2022.1525 [in Ukrainian].