Hyperglycemia is a recognized complication of diarrhea-associated hemolytic-uremic syndrome (D + HUS). Hyperglycemia developed in 8 (6.6%) of 121 patients with D + HUS. A literature review revealed a further 11 patients with D + HUS who developed hyperglycemia. The mortality rate in this group of patients is high. Hyperglycemia is more common in patients with D + HUS uremic syndrome who are female, who have an elevated white blood cell count on admission, and who develop anuria or a central nervous system complication.

Cold exposure elicits several thermoregulatory responses, including an increased metabolic heat production from shivering and nonshivering thermogenesis. The increased metabolism can be in response to body core and/or body cutaneous cooling. Hypoxic hypoxia has been shown to attenuate the metabolic response to cutaneous cooling. We measured metabolic heat production in adult conscious rats during independent cutaneous and core cooling, during normoxia and hypoxia, to 1) test the hypothesis that hypoxia suppresses the metabolic response to independent core cooling and 2) determine whether hypoxia acts preferentially on the response to cutaneous or core cooling. The animals were studied in a temperature-controlled metabolic chamber, and body core temperature was controlled by an abdominal heat exchange coil. Ambient temperature was varied (10, 19, and 28 degrees C) while core temperature was clamped at 37 degrees C or core temperature was varied (33, 35, and 37 degrees C) at a stable ambient temperature of 28 degrees C. Our data indicate that although the sensitivity of the metabolic response to core cooling is about five to six times that to cutaneous cooling. Hypoxia similarly attenuates thermoregulatory responses to both stimuli.

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