Vol 70, No 3 (2019)
Review paper
Published online: 2019-06-30

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Hypoglycaemia in endocrine, diabetic, and internal diseases [Hipoglikemia w schorzeniach endokrynologicznych, diabetologicznych i internistycznych]

Dominika Rokicka1, Bogdan Marek2, Dariusz Kajdaniuk2, Marta Wróbel1, Aleksandra Szymborska-Kajanek1, Monika Ogrodowczyk-Bobik3, Agata Urbanek, Szymon Janyga3, Halina Borgiel-Marek4, Krzysztof Strojek1
Pubmed: 31290559
Endokrynol Pol 2019;70(3):277-297.

Abstract

Hypoglycemia is a decrease in blood glucose concentration below the physiological level. It occurs in healthy people and in people with various diseases with inadequate secretion of insulin by β cells, or deficiency of counterregulatory hormones secreted at the moment of hypoglycemia. Hypoglycemia is also associated with diabetes therapy, regardless of whether behavioral therapy, oral hypoglycemic agents, or insulin are used. Distinguishing the causes of hypoglycemia is the basis for taking appropriate therapeutic actions that protect patients against subsequent episodes of lowering blood glucose and complications caused by hypoglycemia.

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References

  1. Laidler P, Kuciel R, Wróbel M. Prawidłowy metabolizm ustroju człowieka i jego zaburzenia w cukrzycy. In: Sieradzki J. ed. Cukrzyca. Tom I. Via Medica, Gdańsk 2015.: 9–30.
  2. Konturek S. Fizjologia człowieka. Podręcznik dla studentów medycyny. Elsevier Urban and Partner, Wrocław 2013.
  3. Sprague JE, Arbeláez AM. Glucose counterregulatory responses to hypoglycemia. Pediatr Endocrinol Rev. 2011; 9(1): 463–73; quiz 474.
  4. Konturek SJ, Konturek JW. Cephalic phase of pancreatic secretion. Appetite. 2000; 34(2): 197–205.
  5. Cryer PE. Glucose counterregulation: prevention and correction of hypoglycemia in humans. Am J Physiol. ; 1993: 149–155.
  6. Yosten GLC. Alpha cell dysfunction in type 1 diabetes. Peptides. 2018; 100: 54–60.
  7. Cooperberg BA, Cryer PE. Insulin reciprocally regulates glucagon secretion in humans. Diabetes. 2010; 59(11): 2936–2940.
  8. Cryer P. The prevention and correction of hypoglycemia . In: Jefferson LS, Goodman HM. ed. Handbook of physiology. Section 7. The endocrine system. Vol. II. The endocrine pancreas and regulation of metabolism. American Physiological Society, Bethesda 2001: 1057–1092.
  9. Matschinsky FM. Banting Lecture 1995. A lesson in metabolic regulation inspired by the glucokinase glucose sensor paradigm. Diabetes. 1996; 45(2): 223–241.
  10. Exton JH. Mechanisms of hormonal regulation of hepatic glucose metabolism. Diabetes Metab Rev. 1987; 3(1): 163–183.
  11. Dufour S, Lebon V, Shulman GI, et al. Regulation of net hepatic glycogenolysis and gluconeogenesis by epinephrine in humans. Am J Physiol Endocrinol Metab. 2009; 297(1): E231–E235.
  12. Tesfaye N, Seaquist ER. Neuroendocrine responses to hypoglycemia. Ann N Y Acad Sci. 2010; 1212: 12–28.
  13. Watts AG, Donovan CM. Sweet talk in the brain: glucosensing, neural networks, and hypoglycemic counterregulation. Front Neuroendocrinol. 2010; 31(1): 32–43.
  14. Meneilly GS, Cheung E, Tuokko H. Altered responses to hypoglycemia of healthy elderly people. J Clin Endocrinol Metab. 1994; 78(6): 1341–1348.
  15. Fanelli C, Pampanelli S, Epifano L, et al. Relative roles of insulin and hypoglycaemia on induction of neuroendocrine responses to, symptoms of, and deterioration of cognitive function in hypoglycaemia in male and female humans. Diabetologia. 1994; 37(8): 797–807.
  16. Merl V, Kern W, Peters A, et al. Differences between nighttime and daytime hypoglycemia counterregulation in healthy humans. Metabolism. 2004; 53(7): 894–898.
  17. International Hypoglycaemia Study Group. Glucose Concentrations of Less Than 3.0 mmol/L (54 mg/dL) Should Be Reported in Clinical Trials: A Joint Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2017; 40(1): 155–157.
  18. Zalecenia kliniczne dotyczące postępowania u chorych na cukrzycę 2018. Stanowisko Polskiego Towarzystwa Diabetologicznego. Diabetologia Kliniczna. 2018; 2(supl. A): A30.
  19. Strojek K. Diabetologia. Praktyczny poradnik. Termedia Wydawnictwo Medyczne, Poznań 2014: 47–49.
  20. Stratton IM. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000; 321(7258): 405–412.
  21. Klupa T, Szewczyk A. Leczenie osobistą pompą insulinową. Podręcznik dla pielęgniarek i położnych. Wydawnictwo Lekarskie PZWL, Warszawa 2015: 86–89.
  22. Rokicka D. Zasady leczenia insuliną. Rola nowych insulin w leczeniu chorych na cukrzycę. Diabetologia. Wybrane zagadnienia. 2017: 16–22.
  23. Pilemann-Lyberg S, Thorsteinsson B, Snorgaard O. Severe hypoglycaemia during treatment with sulphonylureas in patients with type 2 diabetes in the Capital Region of Denmark. Diabetes Res Clin Pract. 2015; 110(2): 202–207.
  24. Bolli G, de Feo P, Compagnucci P, et al. Abnormal glucose counterregulation in insulin-dependent diabetes mellitus. Interaction of anti-insulin antibodies and impaired glucagon and epinephrine secretion. Diabetes. 1983; 32(2): 134–141.
  25. Gerich JE, Langlois M, Noacco C, et al. Lack of glucagon response to hypoglycemia in diabetes: evidence for an intrinsic pancreatic alpha cell defect. Science. 1973; 182(4108): 171–173.
  26. Hirsch BR, Shamoon H. Defective epinephrine and growth hormone responses in type I diabetes are stimulus specific. Diabetes. 1987; 36(1): 20–26.
  27. Dagogo-Jack S, Cryer PE. Seminal contributions to the understanding of hypoglycemia and glucose counterregulation and the discovery of HAAF (Cryer syndrome). Diabetes Care. 2015; 38(12): 2193–2199.
  28. Marek B, Kajdaniuk D, Kos-Kudła B, et al. Insulinoma — diagnostyka i leczenie. Endokrynol Pol. 2007; 58(1): 58–62.
  29. Kos-Kudła B, Blicharz-Dorniak J, Strzelczyk J, et al. Consensus Conference, Polish Network of Neuroendocrine Tumours. Diagnostic and therapeutic guidelines for gastro-entero-pancreatic neuroendocrine neoplasms (recommended by the Polish Network of Neuroendocrine Tumours). Endokrynol Pol. 2013; 64(6): 418–443.
  30. Kos-Kudła B, Rosiek V, Borowska M. Pancreatic neuroendocrine neoplasms — management guidelines (recommended by the Polish Network of Neuroendocrine Tumours). Endokrynol Pol. 2017; 68(2): 169–197.
  31. Ethun CG, Postlewait LM, Baptiste GG, et al. Small bowel neuroendocrine tumors: A critical analysis of diagnostic work-up and operative approach. J Surg Oncol. 2016; 114(6): 671–676.
  32. Ramage JK, Ahmed A, Ardill J, et al. UK and Ireland Neuroendocrine Tumour Society. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut. 2012; 61(1): 6–32.
  33. Gabriel M, Decristoforo C, Kendler D, et al. 68Ga-DOTA-Tyr3-octreotide PET in neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and CT. J Nucl Med. 2007; 48(4): 508–518.
  34. Bongetti E, Lee MH, Pattison DA, et al. Diagnostic challenges in a patient with an occult insulinoma:Ga-DOTA-exendin-4 PET/CT and Ga-DOTATATE PET/CT. Clin Case Rep. 2018; 6(4): 719–722.
  35. Parihar AS, Vadi SK, Kumar R, et al. 68Ga DOTA-Exendin PET/CT for Detection of Insulinoma in a Patient With Persistent Hyperinsulinemic Hypoglycemia. Clin Nucl Med. 2018; 43(8): e285–e286.
  36. Imhof A, Brunner P, Marincek N, et al. Response, survival, and long-term toxicity after therapy with the radiolabeled somatostatin analogue [90Y-DOTA]-TOC in metastasized neuroendocrine cancers. J Clin Oncol. 2011; 29(17): 2416–2423.
  37. Yanagiya S, Cho KY, Nakamura A, et al. The Effect of Everolimus on Refractory Hypoglycemia in a Patient with Inoperable Metastatic Insulinoma Evaluated by Continuous Glucose Monitoring. Intern Med. 2018; 57(17): 2527–2531.
  38. Chen J, Wang C, Han J, et al. Therapeutic effect of sunitinib malate and its influence on blood glucose concentrations in a patient with metastatic insulinoma. Expert Rev Anticancer Ther. 2013; 13(6): 737–743.
  39. Valli V, Blandamura S, Pastorelli D, et al. Nesidioblastosis coexisting with non-functioning islet cell tumour in an adult. Endokrynol Pol. 2015; 66(4): 356–360.
  40. Ziora K, Oświęcimska J, Dyduch A. Wybrane aspekty patogenetyczne i kliniczne przetrwałej hipoglikemii hiperinsulinemicznej u dzieci. Endokrynologia Pediatryczna. 2006; 5(2): 65–74.
  41. Buraczewska M, Szymanska E, Brandt A, et al. Congenital hyperinsulinism in Polish patients--how can we optimize clinical management? Endokrynol Pol. 2015; 66(4): 322–328.
  42. Palladino AA, Stanley CA. The hyperinsulinism/hyperammonemia syndrome. Rev Endocr Metab Disord. 2010; 11(3): 171–178.
  43. Corrêa-Giannella ML, Freire DS, Cavaleiro AM, et al. Hyperinsulinism/hyperammonemia (HI/HA) syndrome due to a mutation in the glutamate dehydrogenase gene. Arq Bras Endocrinol Metabol. 2012; 56(8): 485–489.
  44. Cammarata-Scalisi F, Avendaño A, Stock F, et al. Beckwith-Wiedemann syndrome: clinical and etiopathogenic aspects of a model genomic imprinting entity. Arch Argent Pediatr. 2018; 116(5): 368–373.
  45. Wong SL, Priestman A, Holmes DT. Recurrent hypoglycemia from insulin autoimmune syndrome. J Gen Intern Med. 2014; 29(1): 250–254.
  46. Bortolotti D, Mothe-Satney I, Ferrari P, et al. Spontaneous hypoglycaemia in the presence of both anti-insulin antibody and anti-insulin receptor antibody. Diabetes Metab. 2006; 32(6): 598–603.
  47. Kalra S, Unnikrishnan AG, Sahay R. The hypoglycemic side of hypothyroidism. Indian J Endocrinol Metab. 2014; 18(1): 1–3.
  48. Kim SeY. Endocrine and metabolic emergencies in children: hypocalcemia, hypoglycemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis. Ann Pediatr Endocrinol Metab. 2015; 20(4): 179–186.
  49. Lewandowski KC, Malicka K, Dąbrowska K, et al. Addison's disease concomitant with corticotropin deficiency and pituitary CRH resistance — a case report. Endokrynol Pol. 2017; 68(4): 468–471.
  50. Bancos I, Hahner S, Tomlinson J, et al. Diagnosis and management of adrenal insufficiency. Lancet Diabetes Endocrinol. 2015; 3(3): 216–226.
  51. Zgliczyński W. Wielka Interna. Endokrynologia. Medical Tribune Polska, Warszawa 2011: 462–471.
  52. Takai M, Kaneto H, Kamei S, et al. A case of hypothalamic hypopituitarism accompanied by recurrent severe hypoglycemia. Springerplus. 2015; 4: 173.
  53. Jameson JL, DeGroot LJ. Endocrinology: adult & pediatric. Wyd. 7. Elsevier, Amsterdam 2016.
  54. Fukuda I, Asai A, Nagamine T, et al. Levels of glucose-regulatory hormones in patients with non-islet cell tumor hypoglycemia: including a review of the literature. Endocr J. 2017; 64(7): 719–726.
  55. Wu JC, Daughaday WH, Lee SD, et al. Radioimmunoassay of serum IGF-I and IGF-II in patients with chronic liver diseases and hepatocellular carcinoma with or without hypoglycemia. J Lab Clin Med. 1988; 112(5): 589–594.
  56. Malenda A, Nowis DA. Znaczenie metabolizmu glukozy w diagnostyce oraz terapii nowotworów układów krwiotwórczego i chłonnego. Hematologia. 2013; 4(3): 227–238.
  57. Moen MF, Zhan M, Hsu VD, et al. Frequency of hypoglycemia and its significance in chronic kidney disease. Clin J Am Soc Nephrol. 2009; 4: 1121–1127.
  58. Horst ES, Johnson C, Lebowitz HE. Carbohydrate metabolism in uremia. Ann Intern Med. 1968; 68: 63–76.
  59. Fiaccadori E, Sabatino A, Morabito S, et al. Hyper/hypoglycemia and acute kidney injury in critically ill patients. Clin Nutr. 2016; 35(2): 317–321.
  60. Anno T, Kaneto H, Shigemoto R, et al. Hypoinsulinemic hypoglycemia triggered by liver injury in elderly subjects with low body weight: case reports. Endocrinol Diabetes Metab Case Rep. 2018; 2018.
  61. Szajewska H, Horvath A, Kłęk S. Interna Szczeklika. Medycyna Praktyczna , Kraków 2018: 1010–1016.
  62. Greenspan F, Gardenr D. Endokrynolgia ogólna i kliniczna. Czelej, Lublin 2004: 767–769.
  63. Bejtka M, Malińska D. Glikogenozy — choroby genetyczne związane z zaburzeniami metabolizmu glikogenu. Postępy Biochemii. 2011; 57(2): 148–157.