1/2. Repeated hypoglycemia and cognitive decline. A case report.OBJECTIVE: diabetes mellitus has a high incidence in general population and goes by high morbidity by specific micro vascular pathology in the retina, renal glomerul and peripheral nerves. In type 1 DM, intensive therapy can prevent or delay the development of long-term complications associated with DM but hypoglycaemia especially severe hypoglycaemia defined, as a low blood glucose resulting in stupor, seizure, or unconsciousness that precludes self-treatment is a serious threat. Hypoglycaemia that may preferentially harm neurons in the medial temporal region, specifically the hippocampus, is a potential danger for the brain cognitive function which several studies failed to detect any significant effects, whereas others indicated an influence on it. A young diabetic case presented here with severe cognitive defect. Great number of severe hypoglycaemic or hyperglycaemic attacks and convulsion episodes were described in his medical history. RESULTS and CONCLUSION: Neuroradiologic findings on CT and MRI, pointed that global cerebral atrophy that is incompatible with his age. brain perfusion studies (SPECT, (99m)Tc-labeled HMPAO) also showed that there were severe perfusion defects at superior temporal region and less perfusion defects at gyrus cingulum in frontal region. These regions are related with memory processing. Severe cognitive defect in this patient seems to be closely related these changes and no another reason was found to explain except the repeated severe hypoglycaemic episodes.- - - - - - - - - - ranking = 1keywords = hypoglycaemia (Clic here for more details about this article) |
2/2. Constant low-dose insulin infusion in severe diabetes mellitus.Eight patients with diabetic ketoacidosis and two patients with hyperosmolar non-ketotic coma have been treated with a constant low-dose insulin infusion technique (2-4 units/hour). In all cases a rapid, smooth control of blood glucose levels was obtained in conjunction with a similar improvement in clinical status and remedying of other biochemical defects. At no stage of therapy did hypoglycaemia or hypokalaemia occur. In the majority of cases control of the patient's metabolic state was achieved within eight to 12 hours. The insulin regime is simple to institute and maintain.- - - - - - - - - - ranking = 0.5keywords = hypoglycaemia (Clic here for more details about this article) |