The patient was thin, with a height of 167 cm and a weight of 55 kg. Because the patient is complicated with hyponatremia and hypoglycemia, it is recommended to carry out endocrine related examination. The results showed that the whole pituitary gland was * * * *, and the MRI showed an empty sella turcica. After steroid and thyroxine supplementation, the patient's condition improved obviously, hypoglycemia no longer appeared, and his weight had risen to 63kg. Therefore, regular follow-up visits are required.
Dr. Guo from the Department of Endocrinology and Metabolism, Zhongxing Hospital, Taipei United Hospital pointed out that the symptoms of hypoglycemia include palpitation, shaking hands, sweating, hunger, dizziness, inattention, confusion, behavior change, coma, convulsions and even death.
Hypoglycemia is defined as:
Have symptoms of hypoglycemia; Measuring the low plasma glucose concentration in an accurate way; When the blood sugar concentration rises, the symptoms will be alleviated. The lower limit of fasting blood glucose is generally defined as 70mg/dL, but sometimes the blood glucose of normal people will be lower than this figure. At present, it is considered that blood sugar is lower than 55mg/dl and symptoms appear. When blood sugar rises and symptoms are relieved, it can be regarded as hypoglycemia. Diabetic patients who receive treatment are more prone to hypoglycemia, but it can also be caused by many reasons, such as organ failure, sepsis, malnutrition, hormone deficiency, insulinoma and so on.
Dr. Guo said that if hypoglycemia is suspected clinically, blood sugar should be tested immediately to confirm the diagnosis. If blood sugar cannot be detected, it is suggested to treat it as hypoglycemia, and the rule of 15 can be adopted, that is, when the blood sugar is lower than 70mg/dL,15g of sugar, such as glucose tablets (powder), sugary drinks or foods, should be supplemented immediately. If the blood sugar is still below 70mg/dL, add 15g sugar and15 minutes before measuring the blood sugar. If the blood sugar is still below 70mg/dL, you need to see a doctor immediately.
If hypoglycemia occurs, be sure to confirm the cause of hypoglycemia to avoid recurrence. The most common reasons are: diabetes-related drugs, such as taking insulin or taking hypoglycemic drugs, but not eating; Do not add sugar after strenuous exercise; If the drug dose is too heavy, it can be improved by adjusting drugs and living habits. Hypoglycemia caused by other reasons depends on different diseases, so there are different treatments. Take this patient as an example. Because of pituitary insufficiency, patients suffer from hormone deficiency, so they have loss of appetite, nausea and vomiting, fatigue, hypoglycemia and electrolyte disorder. Therefore, after hormone supplementation, hypoglycemia will no longer occur, and the symptoms caused by hormone deficiency will be improved. Dr. Guo reminded that hypoglycemia is a common acute complication of diabetic patients, but there are still a few non-diabetic patients who also have hypoglycemia. If you have related symptoms, don't forget to go to the metabolic clinic for consultation.
Subject: hypoglycemia, diabetes, Dr. Guo, Department of Endocrinology and Metabolism, Zhongxing Campus, Taipei United Hospital