1/7. A tumour that secretes glucagon-like peptide-1 and somatostatin in a patient with reactive hypoglycaemia and diabetes.glucagon-like peptide 1 (GLP-1), an insulinotropic hormone normally synthesised in the intestinal mucosa and released in response to a meal, is essential for normal glucose homoeostasis. There is much interest in the use of GLP-1 to treat diabetes, since the risk of hypoglycaemia is thought to be low. We report an instance of a 45-year-old woman with a GLP-1 and somatostatin secreting neuroendocrine tumour who presented with reactive hypoglycaemia and hyperglycaemia, but who was subsequently cured by surgery. This case, of a neuroendocrine tumour secreting GLP-1 and causing reactive hypoglycaemia, indicates a potential adverse effect of GLP-1 therapy for diabetes.- - - - - - - - - - ranking = 1keywords = hypoglycaemia (Clic here for more details about this article) |
2/7. Down's syndrome, hypothyroidism and diabetes mellitus in an adult.Primary hypothyroidism was diagnosed in a woman aged 33 years, with Down's syndrome and insulin-dependent diabetes mellitus after admission to hospital with hypoglycaemia. The diabetes was stabilized and treatment was commenced with L-thyroxine with a good clinical response. The patient's mother and older sister also had hypothyroidism and all three had no thyroid antibodies. The importance of diagnosing and treating primary hypothyroidism in adult patients with Down's syndrome is stressed even in the absence of thyroid antibodies.- - - - - - - - - - ranking = 0.14285714285714keywords = hypoglycaemia (Clic here for more details about this article) |
3/7. diabetes mellitus presenting with ketoacidosis following pentamidine therapy in patients with acquired immunodeficiency syndrome.patients with acquired immunodeficiency syndrome (AIDS) are at risk from many endocrine complications. pentamidine has been recognised for its potential to cause symptomatic, and even life-threatening hypoglycaemia. We report two cases of diabetes mellitus presenting with ketoacidosis 3 to 4 months after pentamidine therapy for pneumocystis carinii pneumonia (PCP), and review our experience of dysglycaemia in 58 patients with AIDS treated with pentamidine. These cases emphasise the potential for severe pancreatic toxicity in patients with AIDS. Hyperglycaemia during pentamidine therapy may be a marker for patients at increased risk of developing diabetes mellitus.- - - - - - - - - - ranking = 0.14285714285714keywords = hypoglycaemia (Clic here for more details about this article) |
4/7. Anaphylactoid reaction to 50% solution of dextrose.Two patients with extrinsic asthma and coexistent insulin-dependent diabetes mellitus sustained an anaphylactoid reaction after the intravenous administration of 50% solution of dextrose. Investigations suggested that the dextrose, rather than any additives, was responsible for the reaction. The effect of varying concentrations of dextrose on the histamine content of the blood of normal, allergic, non-diabetic and diabetic, and non-allergic patients was studied. Preliminary results suggest that the higher concentrations of dextrose induce increased histamine release from blood cells, and that this phenomenon is more marked in diabetic, and particularly diabetic-allergic, individuals. We suggest that the treatment of hypoglycaemia with 50% solution of dextrose is associated with a significant risk factor in those diabetic individuals who are either allergic or are receiving beta-adrenoreceptor blocking drugs.- - - - - - - - - - ranking = 0.14285714285714keywords = hypoglycaemia (Clic here for more details about this article) |
5/7. Corticotrophin, growth hormone and prolactin deficiencies with hypoaldosteronism and corticosteroid-reversible hypothyroidism in Sheehan's syndrome. Clinical and anatomical correlations.Deficiencies of corticotrophin (ACTH), growth hormone, and prolactin were documented in a woman with diabetes mellitus and Sheehan's syndrome. The patient's ACTH deficit appeared to be secondary to a hypothalamic abnormality since on two occasions the patient had a marked plasma ACTH response to vasopressin but not to insulin induced hypoglycaemia. It is postulated that the deficits of these three adenohypophysial hormones were instrumental in causing a severely impaired aldosterone secretory capacity in response to sodium restriction and an angiotensin infusion. In addition, the patient had an unusual form of thyroid dysfunction that was in part reversed with hydrocortisone replacement. The patient's unfortunate death during a hypoglycaemic crisis allowed correlation between her extensive antemortum endocrine testing and her pathologic anatomy.- - - - - - - - - - ranking = 0.14285714285714keywords = hypoglycaemia (Clic here for more details about this article) |
6/7. Communicating hydrocephalus in the intellectual deterioration of diabetes mellitus.atherosclerosis of cerebral vessels (Grunnet 1963) and hypoglycaemia (Bale 1973) are thought to be involved in the premature intellectual deterioration which occurs in some diabetics. Two diabetics are now reported who, in the course of their investigation for intellectual deterioration, were found to have communicating hydrocephalus.- - - - - - - - - - ranking = 0.14285714285714keywords = hypoglycaemia (Clic here for more details about this article) |
7/7. Attempted suicide by insulin overdose in insulin-requiring diabetics.Four cases of suicidal insulin overdose in insulin-requiring diabetics presented to one hospital in three years. In three cases there was a history of depression; but despite huge doses of insulin (3,000 and 1,500 units) in two, no patient died and only one had residual signs of clinical brain damage. The estimated plasma insulin level was not well correlated with the severity of the hypoglycaemia. It is probable that suicidal insulin overdose is more common than reports in the literature suggest, and may often be unrecognized. The dissociation between huge doses of insulin and the severity of the subsequent hypoglycaemia in diabetics is unexplained.- - - - - - - - - - ranking = 0.28571428571429keywords = hypoglycaemia (Clic here for more details about this article) |