Background And Objectives: Among otherwise healthy adults, there is a subgroup of individuals who develop symptoms of hypoglycemia during episodes of food restriction. The aim of the present study was to investigate whether such individuals develop hypoglycemia or react abnormally in other metabolic aspects during a 24-hour fast.
Subjects And Methods: Ninety medical students were asked if they wanted to participate. Sixteen were selected; none dropped out. A 24-hour fast was performed at a hospital ward. Blood samples and questionnaires were taken at eight specific times.
Result: During the fast, the sensitive group reported significantly higher scores on 'irritation' and 'shakiness'. However, no hypoglycemia occurred and the lowest detected blood glucose concentration was 3.7 mmol/l. There were no differences between the groups in plasma glucose, cortisol, growth hormone (GH), insulin, beta-hydroxybutyrate (beta-OH) and lactate levels. The blood pressures and heart rates were also similar.
Conclusions: Adults, despite subjective signs of hypoglycemia, can fast without any metabolic or endocrine derangement.
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http://dx.doi.org/10.1038/sj.ejcn.1602785 | DOI Listing |
Emerg Nurse
January 2025
Faculty of Health Education and Life Sciences, Birmingham City University, Birmingham, England.
Hypoglycaemia is a common cause of presentation to the emergency department (ED) for people with diabetes mellitus. Patients experiencing a hypoglycaemic episode require prompt treatment with fast-acting glucose to prevent brain fuel deprivation and functional brain failure, therefore it is vital that ED nurses can recognise the signs and symptoms of hypoglycaemia and are aware of the factors that can compound or mask it. This article discusses the aetiology and signs and symptoms of hypoglycaemia in adults with type 1 and type 2 diabetes and describes the use of an algorithm for the management of hypoglycaemia in this patient population in hospital.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Diabetes, Greenlane Hospital, Auckland, Auckland, New Zealand.
A woman in her 40s presented with severe post-bariatric hypoglycaemia that persisted despite nutritional therapy and pharmacological therapy with acarbose and subcutaneous octreotide with meals. The nutritional limitations were difficult to sustain, and she developed adverse effects to the pharmacological therapy, and hence, doses could not be increased. She was subsequently treated with subcutaneous octreotide via an insulin pump, with a continuous basal rate and additional bolus doses with meals.
View Article and Find Full Text PDFBackground: Insulinoma is a neuroendocrine tumor, the main manifestation of which is hypoglycemia. However, the symptoms of hypoglycemia can be non-specific for a long time, especially outside provocative conditions, and quite often the tumor manifests from a life-threatening condition - hypoglycemic coma. In this regard, timely laboratory diagnosis of insulinoma and determination of its aggressive course is one of the priorities in modern researches.
View Article and Find Full Text PDFJCEM Case Rep
February 2025
Division of Endocrinology, Diabetes & Metabolic Diseases, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Insulinomas are rare neuroendocrine neoplasms and causes of hypoglycemia. They present with neuroglycopenic symptoms, including confusion and seizures. Suspected diagnosis must be confirmed through bloodwork and imaging.
View Article and Find Full Text PDFGlycogen storage disease type III (GSD III) is a rare metabolic disorder characterized by a deficiency of liver and muscle amylo-1,6-glucosidase. This condition presents with severe hepatic symptoms in childhood, mostly hepatomegaly, hypoglycemia in half of patients, while muscular complications may predominate in adulthood. Hepatic fibrosis, cirrhosis and hepatocellular carcinoma (HCC) are common complications in older patients.
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