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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of diabetic control upon EEG has seldom been studied. In the present investigation, a significant positive correlation between EEG abnormalities and degree of diabetic control was found, but no definite increase was noted in relation to the duration of diabetes. Eighty per cent of our patients having more than 5 severe hypoglycemic attacks showed evidence of abnormal EEG, suggesting that hypoglycemic coma or convulsions are closely related to EEG abnormalities (minor hypoglycemic episodes had no effect on the EEG). With the sensitive technique of fluorescein angiography, we demonstrated a clear correlation between incipient retinal angiopathy and EEG abnormalities. The factors that most positively relate to pathologic electrocerebral (EEG) activity in diabetic children are frequent and severe hypoglycemic attacks, comas and/or convulsions, and vascular changes in the retina.
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PMID:EEG abnormalities in diabetic children: influence of hypoglycemia and vascular complications. 50 56

Fifty-nine patients with chronic pancreatitis were studied in retrospect. The incidence of overt diabetes was high, 36/59. Half of the diabetics were insulin-dependent, and among these labile diabetes with hyperglycemia and high amounts of glucose in the urine was not uncommon. Hypoglycemic episodes were noted in 14 of the 18 insulin-treated patients, and in 3 patients severe hypoglycemia was believed to be the cause of death. Mechanisms leading to such disastrous hypoglycemia are discussed, and a hypothesis regarding lack of glucagon as the cause of severe hypoglycemic attacks was experimentally tested by measuring pancreatic glucagon in plasma in two patients with pancreatic diabetes and severe brain damage following hypoglycemic coma. Low basal glucagon values were found, and the normal rise upon insulin-induced hypoglycemia was not seen. From these results it may be justified to suggest, firstly that glucagon should be used in the management of severe hypoglycemia in chronic pancreatitis, and secondly that a certain degree of hyperglycemia should be allowed in the treatment of diabetes in these patients.
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PMID:Diabetes and hypoglycemia in chronic pancreatitis. 86 1

The undressed body of a young man was discovered in a pit in a forest. The victim was a 27 year old depressed man, suffering from a severe diabetes. Besides personal objects, three empty insulin vials (400 I.U./vial) and empty ampules of distilled water, injection-needles and a syringe were also found in the pit. The investigation carried out at the scene, the questioning of his family and physicians, and the autopsy clarified this unusual case. In conclusion the hypothesis of "suicide" was maintained: the man administered himself a large dose of insulin; in hypoglycaemic coma he died from a bronchopneumonia in a "grave" dug by himself.
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PMID:An extraordinary case: suicide with insulin in a grave dug by the victim himself. 87 73

A case report is presented of a 38-year-old alcoholic welfare patient. Drainage of a pancreatic abscess, which had to be repeated, pyloromyotomy, cholecystectomy and sphincterotomy were undertaken in 1972 at another hospital. He was admitted on the present occasion because of weight loss, severe attacks of pain and diabetes. At operation multiple necrotic areas were found in the pancreas, with many stones in the parenchymatous tissue and in the main pancreatic duct and one large stone close to the pailla acting like a valve. Sub-total duodenopancreatectomy, resection of the pyloric region of the stomach, retrocolic hepaticojejunostomy and gastroenteroanastomosis was performed. The postoperative recovery took place without complications. 5 days after discharge the patient died in a hypoglycaemic coma at another hospital. He had administered 400 U. insulin to himself whilst in a drunken state. A short description is given of the aetiology and pathogenesis of calcifying pancreatitis. The choice of the surgical technique depends on the operative findings and the aim of therapy. Attention is called to the increase in late mortality in patients with pancreatectomy who do not abstain from alcohol.
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PMID:[Fatal outcome of a case with calcifying alcoholic pancreatitis (author's transl)]. 97 84

A 72-year-old male being treated with chlorpropamide for diabetes mellitus had an emergency operation for a perforated gastric ulcer. Hypoglycaemic coma occurred after the operation.
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PMID:Postoperative hypoglycaemic coma associated with chlorpropamide. 120 Nov 69

Type 1 diabetic patients experience symptomatic hypoglycemia once or twice a week. 30% of insulin-treated patients suffer from hypoglycemic coma at least once during their life, 10% at least once a year. 3% are incapacitated by frequent and severe attacks, 3 to 4% die from hypoglycemia. In contrast the incidence of symptomatic hypoglycemia in sulfonylurea-treated patients is about 0.2 per 1000 patients' years, the mortality of severe attacks being about 8%. The cause of hypoglycemia is always an excess of insulin, in absolute or relative terms. Additional precipitating factors are defective counterregulation after longer duration of diabetes, as well as a lowered threshold for counterregulation and/or for perception of warning symptoms, as seen under strict glycemic control. Considering the risks associated with hypoglycemia, preventive measures must be emphasized.
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PMID:[Hypoglycemia in diabetes mellitus]. 129 Mar 16

The authors present two cases of chronic alcoholism in two female patients aged 41 and 52 years without diabetes mellitus, in whom hypoglycaemic coma occurred during the abstinence period. Hypoglycaemia in one patient occurred suddenly as a result of fasting within 24 hours following the last alcohol intake, whereas a severe hypoglycaemia in the second patient was developing progressively during 72 hours; patient did not eat much and the last meal took 24 hours before the onset of hypoglycaemic coma. Diagnosis of hypoglycaemic coma was suspected because as no alcohol or acetic acid smell were felt, no alcohol or methanol was detected in blood (tested only in one patient). Adrenergic reactions were not distinct (no excessive sweating, convulsions, tachycardia). The authors suggest, that a severe hypoglycaemia should be considered in patients suspected of alcoholism, and the treatment should start earlier with intravenous glucose administration.
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PMID:[Hypoglycemic coma in chronic alcoholism]. 166 53

The frequency of symptomatic hypoglycaemic episodes was studied in 411 randomly selected conventionally treated Type 1 diabetic out-patients. Between two consecutive visits to the out-patient clinic each patient filled in a questionnaire at home. The number of hypoglycaemic episodes was then recorded prospectively in a diary for 1 week. From the questionnaires, the (retrospective) frequencies of mild and severe symptomatic hypoglycaemia were 1.6 and 0.029 episodes patient-1 week-1. From the diaries, the (prospective) frequencies of mild and severe hypoglycaemic episodes were 1.8 and 0.027 patient-1 week-1. Symptomatic hypoglycaemia was more frequent on working days than during weekends (1.8:1) and more frequent in the morning than during the afternoon, evening, and night (4.5:2.2:1.4:1). The symptoms of hypoglycaemia were non-specific, heterogeneous, and weakened with increasing duration of diabetes. During their diabetic life, 36% of the patients had experienced hypoglycaemic coma. The frequency of hypoglycaemia was positively, but only weakly, correlated with insulin dose, number of injections, percentage unmodified insulin of the total dose, and HbA1c (mild hypoglycaemia only). The frequency was also negatively, but weakly, correlated with age and HbA1c (episodes with coma only), but not correlated with sex, duration of diabetes, or patients' ratings of worries about mild and severe hypoglycaemia.
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PMID:Symptomatic hypoglycaemia in 411 type 1 diabetic patients. 182 35

Prolonged hypoglycemia induced by acetohexamide (AH) in a patient with noninsulin dependent diabetes mellitus accompanied by primary hypothyroidism was presented. A 74-year-old man who had been treated with AH (500mg, daily) for diabetes mellitus since 1973 was admitted to our hospital in Oct. 1988 because of hypoglycemic coma. On admission, the level of blood glucose was 20mg/dl. Continuous intravenous administration of 10 per cent glucose solution led to improvement in the mental state on the second day. However, the level of blood glucose remained between 30 to 45mg/dl for four days after admission. On the fifth day, a fasting blood glucose level finally reached 75mg/dl. In a thyroid function test, the serum levels of thyroid hormone showed the following decreases: T3 68ng/dl, T4 2.8 micrograms/dl, free T4 0.3ng/dl, while basal TSH levels increased to 50.3 microU/ml. Since anti-thyroid microsomal antibody was positive and thyroid 99mTc-pertechnetate uptake was slightly elevated, the hypothyroidism in this patient was considered to be caused by chronic thyroiditis. Urinalysis was positive for protein. In a renal function test, the blood urea nitrogen was 26.7mg/dl and creatinine 1.7mg/dl, and creatinine clearance decreased to 22ml/min. After thyroid function returned to euthyroid, creatinine clearance improved (41 ml/min). To clarify the relationship between hypothyroidism and the metabolism of AH, the serum levels of AH and its metabolite hydroxyhexamide (HH) following oral administration of AH (500mg) were evaluated before and after thyroxine replacement therapy. The blood glucose level before therapy was lower than that after therapy, and hypoglycemic symptoms were observed early in the second and third morning after AH administration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A case of acetohexamide-induced hypoglycemia: the influence of hypothyroidism on the metabolism of acetohexamide. 201 45

Mature male and female dogs (10) and male baboons (4) were each given a single dose of streptozocin (STZ) (1000 mg/m2) by infusion directly into the left internal carotid artery over a two-hour time period. Serial hematology and serum chemistry profiles and physical observations were made, the animals necropsied at varying times after dosage, and the major organs examined histologically. In dogs, severe weight loss, neutrophilia, electrolyte disturbances, decreased liver function, diabetes and decreased serum amylase levels were the major toxicities. In baboons, weight loss, hypoglycemic coma, diabetes, decreased liver function and electrolyte disturbances were observed. While systemic toxicities were severe in both animal species, central nervous system toxicity was minimal. Cerebral toxicities consisting of edema in two dogs, and focal necrosis in one dog were observed histopathologically. No cerebral toxicity occurred in baboons. Based upon these findings, a phase I clinical trial of intra-arterial (internal carotid artery) STZ in patients with primary/metastatic brain tumors would appear feasible.
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PMID:Preclinical toxicity study of streptozocin infused into the internal carotid artery of dogs and baboons. 215 35


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