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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656076PMC
http://dx.doi.org/10.1590/0100-3984.2015.0253DOI Listing

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Background: The global prevalence of diabetes has been rising rapidly in recent years, leading to an increase in patients experiencing hyperglycemic crises like diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). Patients with impaired renal function experience a delay in insulin clearance, complicating the adjustment of insulin dosing and elevating hypoglycemia risk. Accordingly, this study aims to evaluate the impact of renal function on the safety and efficacy of insulin use in patients with isolated DKA or combined DKA/HHS.

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Development of Nonketotic Hyperglycemia Requiring High-Dose Insulin After Supratherapeutic Amlodipine Ingestion.

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September 2024

Department of Medicine, Suburban Hospital, Johns Hopkins Medicine, Bethesda, Maryland.

Background/objective: Calcium channel blockers, when taken in overdose quantities, can cause hyperglycemia requiring so-called hyperinsulinemic-euglycemic therapy. The objective of this report was to describe a patient with calcium channel blocker toxicity resulting from overdose of amlodipine.

Case Report: A 74-year-old man presented with a fall and loss of consciousness.

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Background: Non-ketotic hyperglycinemia (NKH) is a rare autosomal recessive disorder caused by defects in the glycine cleavage system, leading to elevated glycine levels in the central nervous system. NKH manifests in various forms, with the neonatal type being the most severe and often associated with high mortality and significant neurological impairment. This case report highlights the successful uses of desflurane and nitrous oxide for anesthetic management in a patient with NKH.

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Background: Diabetic striatopathy (DS) is a rare disorder characterized by clinical manifestations of hemichorea, non-ketotic hyperglycemia, and high signal on T1-weighted MRI or high density on CT scan in basal ganglia, typically associated with poor glycemic control.

Objective: This study aimed to analyze clinical characteristics of patients with diabetic striatopathy to raise awareness amongst physicians, especially endocrinologists, about this rare neurological manifestation in patients with diabetes.

Methods: We retrospectively analyzed the data on clinical presentations, laboratory workups, and cranial CT and MRI of six patients with DS who were admitted to our hospital from October 2013 to June 2022.

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Neurological manifestations of nonketotic hyperglycemia are frequently seen, with mainly symptoms of confusion or coma. While hyperglycemia-induced seizures are less common, isolated aphasic status epilepticus is very rare, difficult to diagnose, and may be unrecognized by clinicians. In this case report, a 51-year-old man who presented with confusion and incoherent speech for two weeks is discussed.

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