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Pathophysiology of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Late hypoglycemia of occult diabetes is a form of reactive hypoglycemia, which refers to hypoglycemia that results from abnormal responses to rapid increases in blood glucose levels, due to diet or stress. Reactive hypoglycemia is common and often improperly diagnosed and treated, but can be resolved by diet and lifestyle changes. Reactive hypoglycemia occurs 2–5 hours after food intake. Its three main subtypes are alimentary (within 2 hours), idiopathic (at 3 hours), and late (at 4–5 hours). With late hypoglycemia of occult diabetes, there is a delay in early insulin release from the pancreatic beta cells. This results in an initial exaggeration of hyperglycemia during a glucose tolerance test. In response to this hyperglycemia, exaggerated insulin release causes the late hypoglycemia in 4–5 hours. Affected patients are usually very different from those with early hypoglycemia that occurs in 2–3 hours after food intake. They are usually obese and often have a family history of diabetes mellitus. Treatment is directed at weight reduction. Patients often respond to reduced carbohydrate intake when small meals that are well-spaced occur at multiple times during the day. Therefore, they are all considered to be potential diabetics. Periodic medical evaluations must occur.
The Effects of Pollution, Toxins, and Diet on Behavior
Published in Gail S. Anderson, Biological Influences on Criminal Behavior, 2019
Blood sugar levels are one of the most researched areas in the study of diet and the body’s ability to process diet. There have been many studies that link low blood sugar, or hypoglycemia, to violent or aggressive behavior. The human brain’s sole source of energy is glucose, and normal functioning requires a very high level of glucose per minute. The brain controls all human thought and all voluntary behavior, and it uses nearly 25% of all the available sugar in the body. Sugar, in the form of glucose, is the brain’s only energy source, so anything that has an impact on sugar levels in the bloodstream will impact the brain and therefore will affect the way the brain functions, and so, ultimately, affect behavior. Any drop in the glucose supplied to the brain reduces the brain’s ability to function normally, resulting in panic, irritability, nervousness, and aggression.99 When people are irritable, they are much more likely to act without good emotional control. Reactive hypoglycemia, the most common form of low blood sugar, results in symptoms occurring 2–4 hours after a meal, and drugs and alcohol will intensify the effect.99
Psychiatric Misdiagnosis
Published in Mark S. Gold, R. Bruce Lydiard, John S. Carman, Advances in Psychopharmacology: Predicting and Improving Treatment Response, 2018
Many patients diagnose themselves as hypoglycemic in order to explain their psychiatric symptomatology. There is little if any proof that all such patients have symptomatic hypoglycemia. In fact, Ford et al.42 studied 30 volunteer patients who considered themselves hypoglycemic. Eighteen were found to have reactive hypoglycemia with a glucose 65 mg% or below. However, of these, only 15 had a glucose below 60, 4 below 50, and only 1 below 40. Seven of the 30 had normal glucose tolerance tests and 5 had a diabetic profile during a 5-hr glucose tolerance test. However, there are several conditions which can cause symptomatic hypoglycemia — the most prominent of which are insulinoma and the exogenous administration of insulin.
Simultaneous bilateral shoulder dislocation during pilates reformer exercise: A case report
Published in Physiotherapy Theory and Practice, 2023
Metin Ergün, İhsan Yörük, Ogün Köyağasioğlu
The patient was a 41-year-old female bank clerk. She was participating in sport activities recreationally and did not have any previous history of shoulder or any other joint dislocations, hypermobility, connective tissue conditions (i.e. Ehlers-Danlos Syndrome) or untreated musculoskeletal injuries. The patient was transferred to the emergency department by ambulance after she felt severe pain in both her shoulders due to sudden forward displacement of both arms during Pilates Reformer exercise. In the emergency room, Apolet sign was evident on both sides. Bilateral shoulder range of motion (ROM) in three cardinal planes was significantly restricted. Physical examination revealed no injury to arterio-veno-nervous system. No history of convulsion or hyperlaxity was recorded. There was history of known hypertension and reactive hypoglycemia.
Artificial pancreas systems: experiences from concept to commercialisation
Published in Expert Review of Medical Devices, 2022
David L. Rodríguez-Sarmiento, Fabian León-Vargas, Maira García-Jaramillo
In 2021, Diabeloop also presented a new algorithm called DBL-hu to treat patients with highly unstable type 1 diabetes. This algorithm included 35 new parameters, including a more reactive hypoglycemia minimizer, several insulin release modes for a prandial event, an adjustable duration of insulin action, and digestion rate. The DBL-hu was validated for one month in seven patients [108], and a qualitative study was also conducted to evaluate patient satisfaction with the system [109]. Owing to this evidence, the DBL-hu algorithm also received a CE mark and is expected to be commercialized at the same time as DBLG1 [110].