Genetically determined causes of hypoglycemic syndrome in adults without diabetes

Юкина, М. Ю.; Nuralieva, Nurana; Трошина, Е. А.; Кузнецов, Н. С.; Platonova, Nadezhda

doi:10.21518/2079-701x-2018-4-66-73

“…It can not only significantly improve the quality of life of patients with glucose tolerance but also play a positive role in the control of blood glucose [ 24 , 25 ]. Calisthenics is a kind of aerobic exercise designed according to the theory of traditional Chinese medicine [ 26 ]. The whole exercise process is slow and gentle, which can carry out endurance training and aerobic exercise without causing too much burden to the body [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Calisthenics on Hypoglycemic of Diabetic Patients

Wu

¹

,

Qu

²

2022

BioMed Research International

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Objective. To analyze the effect of calisthenics on hypoglycemic in diabetic patients. Method. From September 2019 to May 2020, 210 patients with type 2 diabetes who were newly diagnosed in our hospital were chosen. They were split into two groups: observation ( n = 105 ) and control ( n = 105 ). Only drug therapy and diet management were given to the control group, whereas the observation group was given calisthenics treatment in addition to regular diet control and medicine. The outcomes of the two groups of patient’s blood glucose levels, BMI, quality of life, and blood lipid index were compared in this study. Results. Before treatment, there was no significant difference in FPG, 2hPG, and HbA1c levels between the two groups ( P > 0.05 ). Compared with before treatment, FPG, 2hPG, and HbA1c were significantly reduced in both groups ( P < 0.05 ). In addition, FPG, 2hPG, and HbA1c in the observation group were significantly lower than those in the control group ( P < 0.05 ). There was no significant difference in BMI between the two groups before treatment ( P > 0.05 ). After treatment, the BMI of the two groups was significantly reduced ( P < 0.05 ), and the BMI of the observation group was significantly lower than that of the control group ( P < 0.05 ). A comparison of the two groups’ SF-36 scale scores before intervention revealed no statistically significant difference ( P > 0.05 ). The observation group’s SF-36 scores were substantially higher than the control group’s after intervention ( P < 0.05 ). After treatment, the TC and HDL-c levels in the observation group were not significantly different from those in the control group ( P > 0.05 ). Compared with the control group, TG and LDL-C levels were significantly decreased, with statistically significant differences ( P < 0.05 ). Conclusion. Based on routine nursing intervention, using calisthenics to treat blood sugar has a significant effect, it not only made the patient’s self-care ability significantly improved, which was worthy of active promotion in clinical practice.

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“…The detection of the pathogenic mutation in ABCC8 in adults with nondiabetic hypoglycemia has been described in isolated cases [6], and we did not find descriptions of combinations of germline mutations in MEN1 and ABCC8 in the literature. Only in the study by Xiao et al in 2019, when searching for new somatic mutations in PNET samples, such a combination of genes was detected in a single case.…”

Section: Discussionmentioning

confidence: 58%

“…Hypoglycemia in CDGM can be hyper-or hypoinsulinemic. Clinical cases have been described of adult patients with mutations in the KCNJ1, ABCC8, GLUD1, GCK, AGL, PGM1, ACADM, ETFA, ETFB, ETFDH, HMGCL, FBP1, ALDOB, PMM2, SLC16A1, INSR and other genes [6]. The diagnosis is confirmed by genetic testing.…”

Section: Other Hereditary Disorders Of Glucose Metabolism With Insuli...mentioning

confidence: 99%

Clinical Case Report of Non-Diabetic Hypoglycemia Due to a Combination of Germline Mutations in the MEN1 and ABCC8 Genes

Yukina,

Solodovnikova,

Popov

et al. 2023

Genes

1

0

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Introduction: Non-diabetic hypoglycemia (NDH) is a collective term including the multiple causes of hypoglycemic syndrome not due to diabetes mellitus. NDH may result from insulinoma, IGF-2-omas, hypocorticism, Hirata’s disease, genital disorders of glucose metabolism, etc. One of the most common causes of NDH faced by an endocrinologist is insulinoma, which in turn can be part of the hereditary syndrome of multiple endocrine neoplasia type 1 (MEN1). Congenital disorders of glucose metabolism in adult patients, on the contrary, are diagnosed extremely rarely, since they usually manifest in childhood. This article presents a unique clinical case of a patient with NDH and genetically verified MEN1 in combination with congenital hyperinsulinism due to an ABCC8 gene mutation. Case Report: A 43-year-old patient with hypoglycemic symptoms from childhood is presented, in whom multiple pancreatic tumors and fluctuations in glycemia from 38.7 mg/dL to 329.7 mg/dL (2.15 to 18.3 mmol/L) were detected in adulthood, but a mild course of hypoglycemic syndrome was noted. Numerous examinations that were performed to establish an accurate diagnosis are described, signs that served as a reason for expanding the complex of studies are indicated, possible pathogenetic mechanisms of the mild course of hypoglycemic syndrome and hyperglycemic conditions are discussed. Conclusion: This case report is original and highlights that we must always remain intolerant of the inexplicable. Conducting an extended gene study can help perform a correct diagnosis in complex cases.

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The first experience of using beta-hydroxybutyrate analysis of capillary blood in the diagnosis of non-diabetic hypoglycemia in adults

Yukina¹,

Troshina²,

Nuralieva³

et al. 2022

Obes. metabol.

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0

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Background: The diagnostic threshold of β-hydroxybutyrate (BHB) at the moment of hypoglycemia in insulinoma was developed for venous blood many years ago, when there were no alternative ways to measure ketones. Number of works, mainly on patients with diabetes mellitus, found differences in the measurement of this indicator in venous and capillary blood, but the results were contradictory. Moreover, this study was not previously used in the diagnosis of non-diabetic hypoglycemia (NDH) in adults on the territory of the Russian Federation.Aim: To estimate the effectiveness of the method for determining BHB in capillary blood and its place in the diagnosis of NDH.Materials and methods: We conducted an experimental, cross-sectional, comparative study and included patients with suspected NDH who underwent a standard fast test. The BHB level in capillary blood was determined every 6 hours during the fast test and at its completion.Results: Based on the results of the fast test, the participants (n=154) were divided into groups: with hyperinsulinemic variant of NDH and IFRoma (n=98; group 1), with hypoinsulinemic variant of NDH /absence of NDH (n=56; group 2). When comparing the level of BHB at the moment of fasting completion, significant differences were obtained between groups 1 and 2 (p<0.001). According to the ROC analysis, the determination of BHB for differentiation the hyper- and hypoinsulinemic variants of hypoglycemia is characterized by excellent quality of model (AUC=99,1% [98,0%; 100,0%]). The BHB determination in capillary blood has the maximum diagnostic accuracy at a cut-off point of ≤ 1.4 mmol/L (Se 98.0%, Sp 96.4%, PPV 98.0%, NPV 96.4%, Ac 97.4%). Exceeding the diagnostic threshold of BHB was first recorded after 24h of fasting; at the same point, a significant difference was determined when comparing BHB indicators between two consecutive measurements (between 18h and 24h).Conclusion: The BHB determination in capillary blood is a highly sensitive and highly specific additional method for the differential diagnosis of NDH variants. The diagnostic threshold for BHB of capillary blood, which allows differentiating hyper- and hypoketonemic variants of NDH, is ≤1.4 mmol / L. It is advisable to initiate control of BHB in the blood no earlier than 18 hours after the start of the fast test.

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Genetically determined causes of hypoglycemic syndrome in adults without diabetes

Cited by 4 publications

References 46 publications

The Effect of Calisthenics on Hypoglycemic of Diabetic Patients

The Effect of Calisthenics on Hypoglycemic of Diabetic Patients

Clinical Case Report of Non-Diabetic Hypoglycemia Due to a Combination of Germline Mutations in the MEN1 and ABCC8 Genes

The first experience of using beta-hydroxybutyrate analysis of capillary blood in the diagnosis of non-diabetic hypoglycemia in adults

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