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Effect of Hypoglycemia on QT Interval in Individuals with and without Type 2 Diabetes: A Randomized Crossover Trial.
J Clin Endocrinol Metab
January 2025
Harvard Medical School, Boston, MA, USA.
Background: Our goal was to determine in healthy individuals and individuals with type 2 diabetes the impact of repeated episodes of hypoglycemia on the corrected QT (QTc) interval and the time course for QTc recovery. Further, since hypoglycemia increases aldosterone and patients with primary aldosteronism have prolonged QTc, we also determined whether mineralocorticoid receptor blockade prevents hypoglycemia-induced QTc alterations.
Methods: Twenty-seven healthy participants completed a double-blinded crossover trial contrasting 3 experimental conditions: 1) euglycemia, 2) hypoglycemia, and 3) hypoglycemia with mineralocorticoid receptor blockade pretreatment.
Intraoperative indocyanine green with ultrasound-guided localization as prodigious adjuncts explicating negative margin in functional insulinoma: A case report.
Int J Surg Case Rep
December 2024
Department of Gastrointestinal and General Surgery, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal.
Introduction And Importance: Insulinomas are rare pancreatic neuroendocrine neoplasms with an incidence of one to four cases per million annually and a 5 % to 10 % association with hereditary multiple endocrine neoplasia type-1. While most insulinomas are benign and well-encapsulated, approximately 6 % may have malignant potential. Intraoperative localization remains a vital component of treatment, often facilitated by modern imaging techniques like intraoperative ultrasound and fluorescence modalities.
View Article and Find Full Text PDFA paradoxical reaction after an oral glucose tolerance test revealed a pheochromocytom.
Neuro Endocrinol Lett
December 2024
Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Minato-ku, Tokyo, Japan.
A 33-year-old Japanese man with a history of atopic dermatitis and asthma had never been diagnosed with any apparent glucose intolerance but had been aware of palpitations for >10 years. A 75g oral glucose tolerance test (OGTT) at his physical examination in March 2021 revealed fasting hyperglycemia and post-load hypoglycemia. An OGTT recheck was performed in May 2021 and was normal.
View Article and Find Full Text PDFHypoglycaemic stimulation of macrophage cytokine release is suppressed by AMP-activated protein kinase activation.
Diabet Med
December 2024
Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter Medical School, Exeter, UK.
Aims: Acute hypoglycaemia promotes pro-inflammatory cytokine production, increasing the risk for cardiovascular events in diabetes. AMP-activated protein kinase (AMPK) is regulated by and influences the production of pro-inflammatory cytokines. We sought to examine the mechanistic role of AMPK in low glucose-induced changes in the pro-inflammatory cytokine macrophage migration inhibitory factor (MIF), which is elevated in people with diabetes.
View Article and Find Full Text PDFA Rare and Aggressive Case of Malignant Insulinoma.
Cureus
November 2024
Department of Internal Medicine, Centro Hospitalar Tondela-Viseu, Viseu, PRT.
Insulinomas are rare pancreatic neuroendocrine tumors (NETs) characterized by autonomous insulin secretion leading to hypoglycemia. Malignant insulinomas are defined by the presence of metastases and present significant therapeutic challenges due to limited treatment options. We report the case of a 69-year-old woman with a two-month history of neuroglycopenic symptoms, including morning headaches, blurred vision, palpitations, and sweating, which were alleviated by sugar intake.
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