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1

El Houda Benchaib, Nour, Aziza El Ouali, Sara Anane, et al. "FACTITIOUSHYPOGLYCEMIA: A DIAGNOSIS NOT TO BE OVERLOOKED." International Journal of Advanced Research 12, no. 07 (2024): 1673–76. http://dx.doi.org/10.21474/ijar01/19216.

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Munchausen syndrome by proxy is a rare psychiatric disorder characterized by inducing symptoms of illness in a child by a close relative, usually the mother, leading to various consultations and more or less invasive medical interventions. Factitious hypoglycemia, a factitious disorder caused by the administration of insulin or other hypoglycemic agents, results in hypoglycemias with severe sequelae. Diagnosis relies on measuring insulin levels, which will be high, and C-peptide levels, which will be low or even undetectable. We report the case of a female infant presenting with factitious hyp
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Abrahamsson, Niclas, Britt Edén Engström, Magnus Sundbom, and F. Anders Karlsson. "Hypoglycemia in everyday life after gastric bypass and duodenal switch." European Journal of Endocrinology 173, no. 1 (2015): 91–100. http://dx.doi.org/10.1530/eje-14-0821.

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DesignGastric bypass (GBP) and duodenal switch (DS) in morbid obesity are accompanied by marked metabolic improvements, particularly in glucose control. In recent years, episodes of severe late postprandial hypoglycemia have been increasingly described in GBP patients; data in DS patients are scarce. We recruited three groups of subjects; 15 GBP, 15 DS, and 15 non-operated overweight controls to examine to what extent hypoglycemia occurs in daily life.MethodsContinuous glucose monitoring (CGM) was used during 3 days of normal activity. The glycemic variability was measured by mean amplitude of
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Büyükkaya Besen, Dilek, Hamdiye Arda Sürücü, and Cansu Koşar. "Self-reported frequency, severity of, and awareness of hypoglycemia in type 2 diabetes patients in Turkey." PeerJ 4 (December 13, 2016): e2700. http://dx.doi.org/10.7717/peerj.2700.

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ObjectivesHypoglycemia is a common side effect of insulin therapy in type 1 and type 2 diabetes. Limited data exist on the frequency of hypoglycemic events in type 2 diabetic patients in Turkey. Our study investigated self-reported hypoglycemic events and awareness of hypoglycemia in Turkish patients with type 2 diabetes.MethodsPeople with type 2 diabetes older than 18 years of age were recruited from the two university hospital diabetes clinics. The frequency and severity of hypoglycemia and awareness of hypoglycemia during the preceding year were determinated using questionnaires by the face
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4

Beattie, Sarah. "Hypoglycemia." Nurse Practitioner 48, no. 10 (2023): 17–23. http://dx.doi.org/10.1097/01.npr.0000000000000100.

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Abstract: Primary care NPs are central to the management of diabetes mellitus, which carries with it the risk of hypoglycemia. Fully understanding risk factors, prevention strategies, and treatment assist in reducing hypoglycemic events. This article details hypoglycemia, risk factors for hypoglycemia, prevention strategies, and appropriate treatment plans.
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Parilo, Miguel A. "Gatifloxacin-Associated Hypoglycemia." Journal of Pharmacy Technology 18, no. 6 (2002): 319–20. http://dx.doi.org/10.1177/875512250201800605.

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Objective: To report a case of prolonged hypoglycemia associated with glyburide and gatifloxacin use. Case Summary: An 82-year-old white woman with diabetes mellitus type 2 and chronic renal insufficiency developed postoperative pneumonia. She had previously been on long-term glyburide therapy. Protracted hypoglycemia after institution of gatifloxacin developed despite discontinuation of oral hypoglycemic therapy. After 2 days of intravenous dextrose, sustained normoglycemia was achieved. Discussion: Hypoglycemic reactions with glyburide and fluoroquinolone antibiotics have been reported, but
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6

Hekimsoy, Zeliha, Sevinç Biberoǧlu, Abdurrahman Çömlekçi, Oktay Tarhan, Cem Mermut, and Kadir Biberoǧlu. "Trimethoprim/sulfamethoxazole-induced hypoglycemia in a malnourished patient with severe infection." European Journal of Endocrinology 136, no. 3 (1997): 304–6. http://dx.doi.org/10.1530/eje.0.1360304.

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Abstract Hypoglycemia resulting from the combination of sulfonylurea and sulfonamides is a recognized drug interaction. Hypoglycemia induced by sulfonamides alone may be encountered less frequently. Because of their structural similarities to sulfonylureas. sulfonamides are liable to facilitate hypoglycemia by increasing insulin release in susceptible individuals. Sulfonamides can potentiate the hypoglycemic effect of sulfonylurea agents when given in combination. We describe a malnourished patient with severe infection who developed hypoglycemia during high-dose trimethoprim/sulfamethoxazole
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7

Johnson, Jeffrey A., Joanne E. Kappel, and M. Nabi Sharif. "Hypoglycemia Secondary to Trimethoprim/Sulfamethoxazole Administration in a Renal Transplant Patient." Annals of Pharmacotherapy 27, no. 3 (1993): 304–6. http://dx.doi.org/10.1177/106002809302700309.

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OBJECTIVE: To report a case of trimethoprim/sulfamethoxazole (TMP/SMX)-induced hypoglycemia in an immunosuppressed renal transplant patient. DATA SOURCES: English-language journal articles and reference texts identified via a MEDLINE search and a bibliographic review of pertinent data sources. DATA SYNTHESIS: Hypoglycemia resulting from the combination of sulfonylureas and sulfonamides is a recognized drug interaction. Hypoglycemia induced by sulfonamides alone may be encountered less frequently. Previously reported cases of TMP/SMX-induced hypoglycemia postulated that the sulfonamide mimics h
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8

Kuragayala, Swarna Deepak, Sumita Nayak, and Khalid Khatib. "Hypoglycemia in hospitalized patients: A sleeping monster." Muller Journal of Medical Sciences and Research 15, no. 1 (2024): 5–11. http://dx.doi.org/10.4103/mjmsr.mjmsr_81_23.

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ABSTRACT Objective: This study describes the incidence and clinical profile of hypoglycemia (including mild, moderate, severe, and recurrent) and its correlation with the time of the day, duration of diabetes mellitus (DM), administration of insulin/oral hypoglycemic agents (OHAs) and diagnosis at admission in hospitalized adult patients. Materials and Methods: This retrospective, observational study analyzed the data of hospitalized patients with episode(s) of hypoglycemia. For each patient, clinical profiles such as age, gender, antidiabetic therapy, timing of hypoglycemic event, duration of
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Haywood, Samuel C., Adam J. Bree, Erwin C. Puente, Dorit Daphna-Iken, and Simon J. Fisher. "Central but not systemic lipid infusion augments the counterregulatory response to hypoglycemia." American Journal of Physiology-Endocrinology and Metabolism 297, no. 1 (2009): E50—E56. http://dx.doi.org/10.1152/ajpendo.90673.2008.

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This study tests the hypothesis that lipids could act as an alternative fuel source in the brain during insulin-induced hypoglycemia. Male Sprague-Dawley rats were subjected to hyperinsulinemic (5 mU·kg−1·min−1) hypoglycemic (∼50 mg/dl) clamps. In protocol 1, intralipid (IL), a fat emulsion, was infused intravenously to prevent the fall in free fatty acid levels that occurs in response to hyperinsulinemic hypoglycemia. Intravenous lipid infusion did not alter the counterregulatory responses to hypoglycemia. To test whether IL could have central effects in mediating the counterregulatory respon
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Chakraborty, Abhishek, and Monika Deb. "Hypoglycemia in breastfed neonates: a hospital-based study." International Journal of Contemporary Pediatrics 10, no. 4 (2023): 479–83. http://dx.doi.org/10.18203/2349-3291.ijcp20230722.

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Background: Neonates has well-coordinated adaptation system which maintains the blood sugar at certain safe level in extra uterine life. However certain intrauterine risk factors alter this adaptation system leading to hypoglycemia in early post-natal period. Most of the time hypoglycemic episodes are transient but sometimes there may be recurrent or prolonged hypoglycemia leading to permanent insult in brain and neurological deficit in post-natal life. Aims and objective of the study was to find out incidence of hypoglycemia in exclusively breastfeed neonates and the risk factors associated w
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11

Singh, Dolat, Hamid Nawaz Ali Memon, Tariq Zaffar Shaikh, and Syed Zulfiquar Ali Shah. "HYPOGLYCEMIA." Professional Medical Journal 22, no. 04 (2015): 408–13. http://dx.doi.org/10.29309/tpmj/2015.22.04.1316.

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Objective: To determine the frequency and severity of hypoglycemia in patientswith liver cirrhosis. Study Design: Cross sectional case series study. Period: Six months.Setting: Liaquat University Hospital Hyderabad. Methods: All the patients of liver cirrhosis,of >12 years of age and of either gender were evaluated for hypoglycemia by assessing theglycemic status through random or fasting blood glucose level. The severity of liver cirrhosiswas identified according to the Child-Pugh classification whereas the severity of hypoglycemiawas grouped in mild, moderate and severe categories. The da
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12

Zahed, Karim, Farzan Sasangohar, Ranjana Mehta, Madhav Erraguntla, Mark Lawley, and Khalid Qaraqe. "Investigating the Efficacy of Using Hand Tremors for Early Detection of Hypoglycemic Events: A Scoping Literature Review." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 62, no. 1 (2018): 1211–15. http://dx.doi.org/10.1177/1541931218621278.

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Diabetes is a prevalent condition affecting millions of patients globally. Some diabetic patients suffer from a deadly condition called Hypoglycemia (sudden drop in blood glucose levels). Continuous Glucose Monitors (CGMs) have been the most pervasive tool used to track blood glucose levels but these tools are invasive and costly. While early detection of hypoglycemia has been studied, current approaches do not leverage tremors; which are a primary symptom of hypoglycemia. A scoping review was conducted to understand the relationship between tremors and hypoglycemia, and to document any effort
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13

Singh, Kuldeep, and Anjali M. Kher. "Clinico-biochemical profile of hypoglycemia in neonates admitted in NICU." International Journal of Contemporary Pediatrics 6, no. 1 (2018): 20. http://dx.doi.org/10.18203/2349-3291.ijcp20184694.

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Background: In high risk neonates’ incidence of hypoglycemia is up to 30%. There is limited evidence-based consensus regarding screening and management of neonates at risk of hypoglycemia. This study was undertaken to know the incidence, clinical profile, sequential blood glucose level upto 72 hours and short-term outcome of neonatal hypoglycemia.Methods: Blood sugar was screened at admission, after feed or D10 bolus, 6, 12, 24, 48 and 72 hours of age. Detailed maternal history and neonatal history, clinical manifestation, management and short-term outcome of hypoglycemic neonates were noted.
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14

Shahid, Madhia, Gabriel Q. Shaibi, Hayley Baines, Pamela Garcia-Filion, Zoe Gonzalez-Garcia, and Micah Olson. "Risk of hypoglycemia in youth with type 2 diabetes on insulin." Journal of Pediatric Endocrinology and Metabolism 31, no. 6 (2018): 625–30. http://dx.doi.org/10.1515/jpem-2018-0014.

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Abstract Background: The objective of this study was to ascertain the risk of hypoglycemia among youth with type 2 diabetes (T2D) on insulin therapy. Methods: Twenty-two youth with T2D on insulin therapy (M=12, F=10, age=14.4±4.0 years) were enrolled from a single pediatric endocrine practice. They were followed-up for 3 months with weekly phone calls and monthly in-person visits to review blood glucose logs and document any signs or symptoms of hypoglycemia (defined as finger stick glucose of ≤70 mg/dL). Episodes of hypoglycemia were categorized into five categories: severe, documented sympto
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Mete, Türkan, and Mustafa Cesur. "Non-diabetic hypoglycemia." Intercontinental Journal of Internal Medicine 1, no. 4 (2023): 94–105. http://dx.doi.org/10.51271/icjim-0021.

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Glucose is the main substrate utilized by the brain, and therefore numerous counterregulatory mechanisms exist to maintain plasma glucose concentration. This makes it rare for hypoglycemia to develop in people who are not taking hypoglycemic drugs, such as insulin or sulfonylureas, for diabetes. The symptoms of hypoglycemia are nonspecific. The presence of Whipple’s triad is necessary for diagnosis. When symptoms occur spontaneously, the patient can be evaluated for hypoglycemia. If this is not possible, then a 72-hour fasting test or a mixed meal tolerance test can be performed to create cond
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16

de Galan, Bastiaan E., Saskia J. Rietjens, Cees J. Tack, et al. "Antecedent Adrenaline Attenuates the Responsiveness to But Not the Release of Counterregulatory Hormones during Subsequent Hypoglycemia." Journal of Clinical Endocrinology & Metabolism 88, no. 11 (2003): 5462–67. http://dx.doi.org/10.1210/jc.2003-030407.

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Abstract Hypoglycemia unawareness is thought to be the consequence of recurrent hypoglycemia, yet the underlying mechanism is still incompletely understood. The aim of the present study was to determine the role of antecedent elevated adrenaline in the pathogenesis of hypoglycemia unawareness. Sixteen healthy volunteers (eight of either sex) participated in two experiments, performed in random order and at least 3 wk apart. During the morning, three consecutive doses of 0.04, 0.06, and 0.08 μg·kg−1·min−1 of adrenaline or matching placebo (normal saline) were infused for the total duration of 1
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17

Sandoval, Darleen A., Deanna L. Aftab Guy, M. Antoinette Richardson, Andrew C. Ertl, and Stephen N. Davis. "Acute, same-day effects of antecedent exercise on counterregulatory responses to subsequent hypoglycemia in type 1 diabetes mellitus." American Journal of Physiology-Endocrinology and Metabolism 290, no. 6 (2006): E1331—E1338. http://dx.doi.org/10.1152/ajpendo.00283.2005.

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Exercise-induced hypoglycemia can occur within hours after exercise in type 1 diabetes mellitus (T1DM) patients. This study tested the hypothesis that an acute exercise bout causes (within hours) blunted autonomic and metabolic responses to subsequent hypoglycemia in patients with T1DM. Twelve T1DM patients (3 W/9 M) were studied during a single-step, 2-h hyperinsulinemic (572 ± 4 pmol/l) hypoglycemic (2.8 ± 0.1 mmol/l) clamp 2 h after either a hyperinsulinemic euglycemic (AM EUG) or hypoglycemic clamp (AM HYPO) or after sitting in a chair with basal insulin infusion (AM CON) or 90 min of mode
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18

Serik, S. A., and V. I. Strona. "Hypoglycemia and cardiac arrhythmias in diabetes mellitus." Ukrainian Therapeutical Journal, no. 3—4 (December 30, 2022): 69–79. http://dx.doi.org/10.30978/utj2022-3-69.

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The article provides an assessment of cardiovascular risks associated with episodes of hypoglycemia in patients with diabetes mellitus. The analysis has been performed for the experimental and clinical data on cardiac arrhythmias during induced hypoglycemia in animal models and in patients with diabetes. The pathogenetic mechanisms of the development of life‑threatening heart rhythm disorders during hypoglycemic states (in particular, changes in autonomic nervous system activation and in the serum level of potassium) have been considered. The nature of electrocardiographic changes preceding th
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Davis, S. N., and D. Tate. "Effects of Morning Hypoglycemia on Neuroendocrine and Metabolic Responses to Subsequent Afternoon Hypoglycemia in Normal Man1." Journal of Clinical Endocrinology & Metabolism 86, no. 5 (2001): 2043–50. http://dx.doi.org/10.1210/jcem.86.5.7495.

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There is general agreement that prior hypoglycemia blunts subsequent hypoglycemic counterregulatory responses. However, there is considerable debate concerning the timing and number of prior hypoglycemic episodes required to cause this blunting effect. The aim of this study was to determine whether one episode of hypoglycemia could modify neuroendocrine, metabolic, and symptom responses to hypoglycemia induced 2 h later. A total of 24 (12 male and 12 female) young, healthy, overnight-fasted subjects participated in a series of glucose clamp studies. A total of 16 individuals underwent 2 random
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Hao, Zhenzhen, Chenchen Li, Jing Li, Yan Gao, Li Guo, and Qian Wang. "Analysis of the Causes of Hypoglycemic Reactions in Patients with Diabetic Nephropathy during the Peri-dialysis Period." International Journal of General Practice Nursing 3, no. 1 (2025): 28–31. https://doi.org/10.26689/ijgpn.v3i1.9719.

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Objective: To provide clinical evidence for controlling the incidence of hypoglycemia in patients with diabetic nephropathy during the peri-dialysis period by analyzing the causes of hypoglycemic reactions in diabetic patients during this period in the hospital. Methods: A total of 56 patients with diabetic nephropathy in the peri-dialysis period (i.e., glomerular filtration rate eGFR < 15ml/(min*1.73 m2) up to three months after dialysis) who received outpatient, inpatient, and hemodialysis treatments in the hospital from June 2022 to December 2023 were selected as the research subjects. T
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Sharma, Suresh K., and Ravi Kant. "Awareness of Symptoms and Early Management of Hypoglycemia among Patients with Diabetes Mellitus." Journal of Diabetes and Endocrinology Association of Nepal 1, no. 1 (2018): 12–17. http://dx.doi.org/10.3126/jdean.v1i1.21190.

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Background: Hypoglycemia mostly occurs in diabetic patients on medications. Lack of awareness on hypoglycemic symptoms among patients may delay its identification and treatment. The symptoms of hypoglycemic symptoms among patients may delay its identification and treatment. Neglecting the symptoms of hypoglycemia and delaying treatment could cause poorer outcomes or morbidity. The present study was aimed to assess the awareness of symptoms of hypoglycemia and knowledge in early management of hypoglycemia among patients with diabetes.Methods: A Cross sectional study was done among 500 diabetes
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Jackson, Lesley, Fiona L. R. Williams, Ann Burchell, Michael W. H. Coughtrie, and Robert Hume. "Plasma Catecholamines and the Counterregulatory Responses to Hypoglycemia in Infants: A Critical Role for Epinephrine and Cortisol." Journal of Clinical Endocrinology & Metabolism 89, no. 12 (2004): 6251–56. http://dx.doi.org/10.1210/jc.2004-0550.

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Abstract The purpose of this study was to define plasma catecholamine responses as part of the counterregulatory hormonal reaction to hypoglycemia in infants after a regular 3- to 4-h feed was omitted. Hormone levels were assessed once, at the end of the fast or at hypoglycemia. The 121 infants were subdivided into three groups for analysis: normoglycemia (n = 94, 78%); transient hypoglycemia (n = 11, 9%); or severe and persistent hypoglycemia (n = 16, 13%). The severe and persistent hypoglycemic group had significantly higher levels of cortisol and epinephrine than the normoglycemic group. No
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Sanders, Nicole M., Charles W. Wilkinson, Gerald J. Taborsky, et al. "The selective serotonin reuptake inhibitor sertraline enhances counterregulatory responses to hypoglycemia." American Journal of Physiology-Endocrinology and Metabolism 294, no. 5 (2008): E853—E860. http://dx.doi.org/10.1152/ajpendo.00772.2007.

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Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed for patients with comorbid diabetes and depression. Clinical case studies in diabetic patients, however, suggest that SSRI therapy may exacerbate hypoglycemia. We hypothesized that SSRIs might increase the risk of hypoglycemia by impairing hormonal counterregulatory responses (CRR). We evaluated the effect of the SSRI sertraline on hormonal CRR to single or recurrent hypoglycemia in nondiabetic rats. Since there are time-dependent effects of SSRIs on serotonin neurotransmission that correspond with therapeutic action, we eva
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Heller, Simon R., Mark Peyrot, Shannon K. Oates, and April D. Taylor. "Hypoglycemia in patient with type 2 diabetes treated with insulin: it can happen." BMJ Open Diabetes Research & Care 8, no. 1 (2020): e001194. http://dx.doi.org/10.1136/bmjdrc-2020-001194.

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There are many misconceptions about the prevalence and effects of hypoglycemia in people with type 2 diabetes (T2D), including hypoglycemia does not occur or does not have adverse consequences in T2D. This narrative review aims to help dispel these myths. Around 25% of people with T2D taking insulin for >5 years were found to have severe hypoglycemic events, which is comparable to the severe hypoglycemia rate in adults with type 1 diabetes (T1D) diagnosed within 5 years. The total number of hypoglycemic events among insulin-treated T2D, including severe hypoglycemia, is as high or higher th
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Makhlina, E. "ESTIMATION OF TYPE 1 DIABETES COMPENSATION BY RESULTS OF GLUCOSE LONG MONITORING." Health and Ecology Issues, no. 3 (September 28, 2008): 56–60. http://dx.doi.org/10.51523/2708-6011.2008-5-3-11.

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Recently in diabetology there were started actively implementing new modern technologies. One of such directions in continuous glucose monitoring system (CGMS). The purpose of the present work is revealing of hypoglycemia fluctuations during the day by CGMS, detection of frequency and duration of hypoglycemic reactions and registration of post hypoglycemic hyperglycemias. The provided data analysis has shown that the period of hyperglycemia made up the basic period of time not depending on patients age. The given fact is caused by chronic insulin overdose due to latent hypoglycemias and a synd
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Mohamed, Ashraf, Christine Bolen, Jennifer Morgan, et al. "Reducing Morning Hypoglycemia Among Children Undergoing Treatment for Acute Lymphoblastic Leukemia." JCO Oncology Practice 17, no. 6 (2021): e901-e907. http://dx.doi.org/10.1200/op.20.00652.

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PURPOSE: Hypoglycemia has been observed in children receiving acute lymphoblastic leukemia (ALL) therapy, and it can negatively affect patient outcomes. We documented a 4%-6% prevalence of hypoglycemia among patients in the two clinics in this study. We aim to reduce morning hypoglycemia in children on chemotherapy for ALL at two community pediatric oncology clinics (A and B) by 50% in 9 months. METHODS: We used the Institute for Healthcare Improvement (IHI) Model for Improvement as the framework. Prolonged hours of fasting for procedural sedation, gaps in the caregivers' knowledge of hypoglyc
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Abs, Roger, Louis Verbist, Marleen Moeremans, Pierre Blockx, Ivo De Leeuw, and Jozef Bekaert. "Hypoglycemia owing to inappropriate glucagon secretion treated with a continuous subcutaneous glucagon infusion system." Acta Endocrinologica 122, no. 3 (1990): 319–22. http://dx.doi.org/10.1530/acta.0.1220319.

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Abstract A selective glucagon deficiency was documented in a 36-year-old female patient suffering from severe hypoglycemic attacks. The extremely low fasting plasma glucagon levels could not be stimulated by hypoglycemia. The increase in plasma glucagon during stimulation with arginine did not prevent hypoglycemia provoked by the simultaneous insulin secretion. Treatment consisting of a continuous sc glucagon infusion system resulted in correction of both postabsorptive and postprandial hypoglycemia. Further lowering of the glucose level during an arginine test could be the hallmark of this hy
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Hilleman, Daniel E., Syed M. Mohiuddin, Ismail S. Ahmed, and Joann M. Dahl. "Cibenzoline-Induced Hypoglycemia." Drug Intelligence & Clinical Pharmacy 21, no. 1 (1987): 38–40. http://dx.doi.org/10.1177/10600280870211p104.

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Antiarrhythmic-induced hypoglycemia is an ill-defined phenomenon. Sporadic cases have been reported with disopyramide, a class IA antiarrhythmic agent. We report a case of cibenzoline-induced hypoglycemia in an elderly male with a history of ischemic heart disease, congestive heart failure, ventricular arrhythmias, and chronic obstructive pulmonary disease. Cibenzoline is a class I antiarrhythmic agent currently undergoing clinical investigation in the U.S. The initial hypoglycemic episode occurred after two years of successful treatment with cibenzoline. Blood glucose during the first hypogly
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Kim, Mina, Zhao-Xue Yu, Bertil B. Fredholm, and Scott A. Rivkees. "Susceptibility of the developing brain to acute hypoglycemia involving A1 adenosine receptor activation." American Journal of Physiology-Endocrinology and Metabolism 289, no. 4 (2005): E562—E569. http://dx.doi.org/10.1152/ajpendo.00112.2005.

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It has been suggested that the developing brain is less vulnerable to the adverse effects of hypoglycemia than the mature brain; however, this issue remains controversial. We also do not know the magnitude or duration of hypoglycemia needed to trigger hypoglycemic brain injury during development. To address this issue a series of in vivo and in vitro studies were performed. First, we established an acute model of insulin-induced hypoglycemia in mice by administering 3 U/kg of neutral-protamine Hagadorn insulin subcutaneously. When we examined degenerating neurons in hippocampus and striatum by
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Shum, Kathy, Karen Inouye, Owen Chan, et al. "Effects of antecedent hypoglycemia, hyperinsulinemia, and excess corticosterone on hypoglycemic counterregulation." American Journal of Physiology-Endocrinology and Metabolism 281, no. 3 (2001): E455—E465. http://dx.doi.org/10.1152/ajpendo.2001.281.3.e455.

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This study aimed to differentiate the effects of repeated antecedent hypoglycemia, antecedent marked hyperinsulinemia, and antecedent increases in corticosterone on counterregulation to subsequent hypoglycemia in normal rats. Specifically, we examined whether exposure to hyperinsulinemia or elevated corticosterone per se could impair subsequent counterregulation. Four groups of male Sprague-Dawley rats were used: 1) normal controls (N) had 4 days of sham antecedent treatment; 2) an antecedent hypoglycemia group (AH) had 7 episodes of hyperinsulinemic hypoglycemia over 4 days; 3) an antecedent
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Matveyenko, Aleksey V., MaryAnn Bohland, Maziyar Saberi, and Casey M. Donovan. "Portal vein hypoglycemia is essential for full induction of hypoglycemia-associated autonomic failure with slow-onset hypoglycemia." American Journal of Physiology-Endocrinology and Metabolism 293, no. 3 (2007): E857—E864. http://dx.doi.org/10.1152/ajpendo.00283.2007.

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Antecedent hypoglycemia leads to impaired counterregulation and hypoglycemic unawareness. To ascertain whether antecedent portal vein hypoglycemia impairs portal vein glucose sensing, thereby inducing counterregulatory failure, we compared the effects of antecedent hypoglycemia, with and without normalization of portal vein glycemia, upon the counterregulatory response to subsequent hypoglycemia. Male Wistar rats were chronically cannulated in the carotid artery (sampling), jugular vein (glucose and insulin infusion), and mesenteric vein (glucose infusion). On day 1, the following three distin
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Yukina, Marina Yu, Nurana F. Nuralieva, Ekaterina A. Troshina, Nikolay S. Kuznetsov, and Nadezhda M. Platonova. "The hypoglycemic syndrome (insulinoma): pathogenesis, etiology, laboratory diagnosis (review, part 1)." Problems of Endocrinology 63, no. 4 (2017): 245–56. http://dx.doi.org/10.14341/probl2017634245-256.

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Hypoglycemic syndrome is a cluster of symptoms developing due to imbalance in the glucose homeostasis system leading to hypoglycemia and that is corrected by glucose administration. A rapid and significant drop of glucose blood level may lead to life-threatening condition, hypoglycemic coma. Chronic hypoglycemia leads to irreversible changes in the central nervous system, while forced frequent meals with high carbohydrate content in order to correct hypoglycemia significantly increases body weight, until morbid obesity develops. Hence, the hypoglycemic syndrome is a topical problem of contempo
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Yukina, M. Yu, N. F. Nuralieva, E. A. Troshina, and V. A. Ioutsi. "Clinical case of factitious hypoglycemia." Meditsinskiy sovet = Medical Council, no. 7 (May 29, 2020): 130–36. http://dx.doi.org/10.21518/2079-701x-2020-7-130-136.

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Hypoglycemic syndrome (HGS) is a significant decrease glucose in blood, manifested by neurological symptoms, and stopped by the introduction of glucose. Among the many causes of HGS the special place is taken by the factitious hypoglycemia, as one of the variants of Munchausen syndrome. Hypoglycemia in such cases is achieved by the intentional introduction of hypoglycemic drugs. The most commonly used medications are sulfonylurea derivatives, which are affordable, inexpensive and legal. The close collaboration of clinicians with the laboratory service plays a key role in the diagnosis of facti
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Yufan, Wang1* Junhua Li2. "Analysis of the Current Situation and Influencing Factors of Hypoglycemia Fear in Patients with Type 2 Diabetes Mellitus." ISRG Journal of Clinical Medicine and Medical Research [ISRGJCMMR] II, no. II (2025): 10–15. https://doi.org/10.5281/zenodo.15009789.

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<strong>Abstract</strong> <strong><em>Objective:</em></strong><em> To investigate the status quo of hypoglycemia fear in type 2 diabetes patients and analyze its influencing factors.</em> <strong><em>Methods:</em></strong><em> The Random sampling method was used to select 200 patients with type 2 diabetes treated in a third-class hospital in Henan province, using the Chinese version of the Hypoglycemia Fear-Worry Scale to investigate the status quo of hypoglycemic fear in type 2 diabetes patients.</em> <strong><em>Results</em></strong><em>: The hypoglycemic dread score of patients with type 2
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Chen, Nai-Ching, Chien-Liang Chen, and Feng-Chih Shen. "The Risk Factors of Severe Hypoglycemia in Older Patients with Dementia and Type 2 Diabetes Mellitus." Journal of Personalized Medicine 12, no. 1 (2022): 67. http://dx.doi.org/10.3390/jpm12010067.

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Background: The adequate glycemic control and risk factors for hypoglycemia in older patients with dementia and type 2 diabetes mellitus (T2DM) remain unclear. This study aimed to analyze the status of glycemic control and determine the risk of hypoglycemia among these groups. Methods: A hospital admission record due to hypoglycemia through an emergency room with glucose supplementation in the Chang Gung Memorial Hospital was identified as a hypoglycemic event. Patients with dementia and T2DM without hypoglycemic events throughout the study period were defined as the control group. We gathered
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Clus, Simona, Gabriela Creteanu, and Amorin Popa. "Silent Hypoglycemia in Patients with Diabetes." Internal Medicine 15, no. 6 (2018): 21–28. http://dx.doi.org/10.2478/inmed-2018-0042.

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AbstractIntroduction. Iatrogenic hypoglycemia increases cardiovascular morbidity sometimes even with fatalities, and also increases cognitive disorders in most people with type 1 diabetes (T1D) and type 2 diabetes (T2D). Hypoglycemia is characterized by unawareness if the sympathoadrenal response is attenuated during the night, in autonomic neuropathy or in elderly patients. Therefore, hypoglycemia is a limiting factor in the glycemic management of diabetes.Methods. We aimed to analyze the hypoglycemic events and the time spent with low glucose level (glucose &lt;3.9 mmol/l) in patients with d
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A, Prameela, and Nirmala M. "A descriptive study to assess the awareness on management of hypoglycaemia among diabetic clients in PSG hospitals." Journal of Scientific and Innovative Research 10, no. 2 (2021): 28–33. http://dx.doi.org/10.31254/jsir.2021.10201.

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Diabetes Mellitus (DM) is a foremost health problem in the globe. Diabetes mellitus describes a metabolic disorder of manifold etiologies characterized by chronic hypoglycemia with disturbances of carbohydrate, fat and protein metabolism. Creating alertness on signs and symptoms among diabetic clients may lessen the complications. The objectives were to assess the knowledge of diabetic clients regarding management of hypoglycemia and to find the association between the knowledge of diabetic clients on management of hypoglycemia and their selected demographic variable. The descriptive survey de
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Lyu, Young Sang, Jin Hwa Kim, and Sang Yong Kim. "Differential Diagnosis of Hypoglycemia." Korean Journal of Medicine 96, no. 6 (2021): 484–92. http://dx.doi.org/10.3904/kjm.2021.96.6.484.

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Hypoglycemia is common but can lead to life-threatening consequences. Accurate diagnosis is important to establish the appropriate treatment strategy. Most cases of hypoglycemia are caused by hypoglycemic agents, although it can occur in individuals without diabetes. A systemic and comprehensive diagnostic approach is required to diagnose hypoglycemia in patients without diabetes. It is important to perform appropriate blood testing during an episode of hypoglycemia. This review will focus on the definition, differential diagnosis, causes, and treatment of hypoglycemia, particularly in people
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Syed, Shumail, and Alain Joseph Taylon. "Losartan Induced Hypoglycemia in the Absence of Diabetes Mellitus - a Concealed Diagnosis." Journal of the Endocrine Society 5, Supplement_1 (2021): A391. http://dx.doi.org/10.1210/jendso/bvab048.796.

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Abstract Background: Losartan has been shown to attenuate symptomatic and hormonal responses to hypoglycemia in prior studies. This results predominantly from blocking AT-II receptors blunting the hypoglycemia-induced rise in plasma epinephrine predisposing them to hypoglycemia unawareness. To our knowledge, however there are no case reports describing losartan induced hypoglycemia in a nondiabetic patient. This abstract is the first description of a patient without diabetes mellitus experiencing severe hypoglycemia induced by the ARB, Losartan. Clinical Case: A 51- year old nondiabetic female
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Hong, Susana, Lubaina Presswala, Yael T. Harris, et al. "Hypoglycemia in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Prospective Observational Study." Kidney360 1, no. 9 (2020): 897–903. http://dx.doi.org/10.34067/kid.0001272020.

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BackgroundGlycemic management in patients with type 2 diabetes mellitus (T2DM) and CKD can become complicated. One factor that may affect treatment is hypoglycemia. Hypoglycemia risk may be increased by several biologic processes in CKD. The objective of this study was to determine the frequency, severity, and risk factors for hypoglycemia in patients with T2DM and CKD.MethodsThe design was a prospective observational study. A continuous glucose monitor (CGM) was worn by 80 patients for up to 14 days; glucose was measured every 15 minutes. Patients with T2DM and eGFR &lt;45 ml/min were enrolle
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Boeder, Schafer C., Justin M. Gregory, Erin R. Giovannetti, and Jeremy H. Pettus. "SGLT2 Inhibition Increases Fasting Glucagon but Does Not Restore the Counterregulatory Hormone Response to Hypoglycemia in Participants With Type 1 Diabetes." Diabetes 71, no. 3 (2021): 511–19. http://dx.doi.org/10.2337/db21-0769.

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Individuals with type 1 diabetes have an impaired glucagon counterregulatory response to hypoglycemia. Sodium—glucose cotransporter (SGLT) inhibitors increase glucagon concentrations. We evaluated whether SGLT inhibition restores the glucagon counterregulatory hormone response to hypoglycemia. Adults with type 1 diabetes (n = 22) were treated with the SGLT2 inhibitor dapagliflozin (5 mg daily) or placebo for 4 weeks in a randomized, double-blind, crossover study. After each treatment phase, participants underwent a hyperinsulinemic-hypoglycemic clamp. Basal glucagon concentrations were 32% hig
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Whitley, Nathaniel T., Kenneth J. Drobatz, and David L. Panciera. "Insulin overdose in dogs and cats: 28 cases (1986–1993)." Journal of the American Veterinary Medical Association 211, no. 3 (1997): 326–30. http://dx.doi.org/10.2460/javma.1997.211.03.326.

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Objective— To characterize the frequency, medical history, clinical signs, methods of treatment, and outcome of insulin-induced hypoglycemia and to identify predisposing factors. Design— Retrospective study. Animals— 8 dogs and 20 cats with diabetes mellitus that developed hypoglycemia because of insulin overdose. Procedure— Medical records of dogs and cats receiving insulin for treatment of diabetes mellitus were reviewed. Medical records of dogs and cats that had an episode of hypoglycemia were reviewed in detail. Results— Overdosing of insulin was more common in cats than in dogs. Median we
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Hanley, James F., Darin D. Willardsen, and Robert Biberdorf. "Profound Hypoglycemia in a Mail-Order Pharmacy Customer as a Result of a Dispensing Error." Hospital Pharmacy 37, no. 7 (2002): 734–36. http://dx.doi.org/10.1177/001857870203700714.

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Accidental hypoglycemia is most commonly associated with the inadvertent ingestion of oral hypoglycemic drugs, and profound hypoglycemia can result in significant morbidity and mortality. Dispensing errors involving sulfonylureas are usually cited as the cause, and these errors have historically been related to sound-alike compounds or proximity errors. We present the case of a patient who received sulfonylureas meant for a different patient through the mail and simply complied with the instructions on the medication bottle, with the result of severe hypoglycemia. This case demonstrates the ne
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K.C., Indu. "Causes of Hypoglycemia in Hospitalized Diabetic Patients Referred to Endocrine Department of a Tertiary Level Hospital of India." Medical Journal of Shree Birendra Hospital 15, no. 1 (2016): 26–31. http://dx.doi.org/10.3126/mjsbh.v15i1.15018.

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Introduction: Diabetes mellitus (DM) results from relative deficiency or reduced effectiveness of endogenous insulin leading to both micro-vascular and macro-vascular complications. Treatment goal is intensive therapy as early as possible in patients with both type-1 and type-2 diabetes to bring the HbA1c to less than 7%. Occurrence of hypoglycemia in a diabetic patient is a common side effect of treatment. This study was aimed to find the causes of Hypoglycemia in diabetes patients. Methods: It was hospital based cross-sectional observational study on admitted diabetes patients with other co-
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She, Rui, Naba Hassan Al-sari, Ismo Matias Mattila, et al. "Decreased branched-chain amino acids and elevated fatty acids during antecedent hypoglycemia in type 1 diabetes." BMJ Open Diabetes Research & Care 11, no. 3 (2023): e003327. http://dx.doi.org/10.1136/bmjdrc-2023-003327.

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IntroductionHypoglycemia is a major limiting factor in achieving recommended glycemic targets for people with type 1 diabetes. Exposure to recurrent hypoglycemia results in blunted hormonal counter-regulatory and symptomatic responses to hypoglycemia. Limited data on metabolic adaptation to recurrent hypoglycemia are available. This study examined the acute metabolic responses to hypoglycemia and the effect of antecedent hypoglycemia on these responses in type 1 diabetes.Research design and methodsTwenty-one outpatients with type 1 diabetes with normal or impaired awareness of hypoglycemia par
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Antonova, K. V., O. V. Lagoda, and M. M. Tanashyan. "Hypoglycemia in type 2 diabetes mellitus patients — cerebral, cognitive, psychosocial and clinical aspects." Diabetes mellitus 25, no. 3 (2022): 288–98. http://dx.doi.org/10.14341/dm12840.

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The review article describes modern approaches to hypoglycemia in diabetes mellitus (DM) patients, its clinical and laboratory diagnostics, and its current classification. Hypoglycemia has the highest impact on cardiovascular morbidity and mortality, including stroke. Cerebral damage in neuroglycopenia, as well as neurological aspects in this group of patients, are discussed. The authors describe glycopenia’s influence on cerebral metabolism, counter-regulatory response, and impaired hypoglycemia recognition, as well as modern neuroimaging techniques that may enhance differential diagnostics i
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Hollinger, B. R., and R. M. Bryan. "Beta-receptor-mediated increase in cerebral blood flow during hypoglycemia." American Journal of Physiology-Heart and Circulatory Physiology 253, no. 4 (1987): H949—H955. http://dx.doi.org/10.1152/ajpheart.1987.253.4.h949.

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We tested the hypothesis that beta-adrenergic receptor stimulation is involved with the increase in regional cerebral blood flow (rCBF) during hypoglycemia. Rats were surgically prepared with the use of halothane-nitrous oxide anesthesia. A plaster restraining cast was placed around the hindquarters, and anesthesia was discontinued. Hypoglycemia was produced by an intravenous injection of insulin (15 U/kg); normoglycemic control rats were given saline. Propranolol (1.5 mg/kg) was administered to some control and some hypoglycemic rats to block the beta-adrenergic receptors. Regional CBF was me
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Moin, Abu Saleh Md, Hassan Kahal, Ahmed Al-Qaissi, et al. "Amyloid-related protein changes associated with dementia differ according to severity of hypoglycemia." BMJ Open Diabetes Research & Care 9, no. 1 (2021): e002211. http://dx.doi.org/10.1136/bmjdrc-2021-002211.

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IntroductionHypoglycemia in type 2 diabetes (T2D) may increase risk for Alzheimer’s disease (AD), but no data on changes in AD-related proteins with differing degrees of hypoglycemia exist. We hypothesized that milder prolonged hypoglycemia would cause greater AD-related protein changes versus severe transient hypoglycemia.Research design and methodsTwo prospective case-control induced hypoglycemia studies were compared: study 1, hypoglycemic clamp to 2.8 mmol/L (50 mg/dL) for 1 hour in 17 subjects (T2D (n=10), controls (n=7)); study 2, hypoglycemic clamp to 2.0 mmol/L (36 mg/dL) undertaken tr
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Petrukhin, A. B. "Hypoglycemic syndrome: etiological factors, diagnosis and treatment algorithm." Spravočnik vrača obŝej praktiki (Journal of Family Medicine), no. 7 (May 25, 2024): 17–22. http://dx.doi.org/10.33920/med-10-2407-02.

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hypoglycemic syndrome is a symptom complex that develops due to an imbalance in the system of maintaining blood glucose levels with the development of hypoglycemia and is stopped by the administration of glucose. A rapid and significant drop in glycemia can lead to a life—threatening condition - hypoglycemic coma. Chronic hypoglycemia leads to irreversible changes in the central nervous system, and forced frequent meals with a high content of easily digestible carbohydrates lead to an increase in body weight up to the development of morbid obesity. Thus, hypoglycemic syndrome is an urgent prob
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Urlaeva, Inna. "Hypoglycemia, an obstacle to achieving glycemic control. Importance of blood glucose self-monitoring." Clinical review for general practice 2, no. 7 (2021): 40–44. http://dx.doi.org/10.47407/kr2021.2.7.00087.

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Hypoglycemia is a well-known factor, limiting the patient's ability to achieve adequate glycemic control, and capable of causing a number of car-diovascular diseases (CVDs). Recurrent hypoglycemia may result in severe, potentially fatal complication of diabetes mellitus (DM), the impaired hypoglycemia awareness, raising the risk of severe hypoglycemia up up to six times. Measuring blood glucose levels is a universally accepted com-ponent of glycemic control and one of the strategies for prevention of hypoglycemia, along with the structured patient education in DM manage-ment and the use of mod
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