Hypoglycemia and the Toxic Effects of Insulin

Harrop, George A.

doi:10.1001/archinte.1927.00130080090008

Cited by 15 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Behavioural changes are known to occur in both adults and children, 10 but in adults, these changes are usually not evident until neuroglycopenia is profound. 11 Parents and other adult carers, such as schoolteachers, childminders, and activity group leaders, have a prominent role in the management of diabetes in children, particularly in the early detection and treatment of hypoglycaemia. Behavioural changes associated with hypoglycaemia may therefore be more readily observed and interpreted in children.…”

Section: Discussionmentioning

confidence: 99%

Hypoglycaemic symptoms reported by children with Type 1 diabetes mellitus and by their parents

et al. 1998

View full text Add to dashboard Cite

To compare the hypoglycaemic symptoms reported by children with Type 1 diabetes and signs observed by and symptoms reported to their parents, 101 pairs, consisting of a child with diabetes and one of their parents, were asked to report the frequency with which they experienced, or witnessed, each of 31 symptoms during hypoglycaemia. The hypoglycaemic symptoms reported by the children and the reported symptoms and signs observed by their parents were classified, using multivariate statistical analyses, and compared. Close agreement was observed between the children and their respective parents' scores for frequencies of most symptoms/signs, as demonstrated by Spearman's rank correlations (median tau s = 0.25, p < 0.02). Principal Components Analysis of the symptoms/signs observed by the parents showed three factors: autonomic, neuroglycopenic, and behavioural disturbance. Analysis of the symptoms experienced by the children also identified three factors: behavioural disturbance, malaise and a third factor consisting of a combination of autonomic and neuroglycopenic symptoms. The parents could differentiate three separate groups of reported hypoglycaemic symptoms and signs (autonomic, neuroglycopenic, and behavioural disturbance) in their children. The children reported a similar group of behavioural symptoms but did not discriminate between autonomic and neuroglycopenic symptoms. These findings have important implications for the education of parents and children with Type 1 diabetes regarding the symptoms and signs of hypoglycaemia.

show abstract

Section: Discussionmentioning

confidence: 99%

Hypoglycaemic symptoms reported by children with Type 1 diabetes mellitus and by their parents

et al. 1998

View full text Add to dashboard Cite

show abstract

“…They later observed that the described symptom‐complex may develop even when the blood sugar content is not lowered to hypoglycemic levels and, conversely, that there may be no hypoglycemic symptoms with markedly depressed blood sugar levels (2, 3). Subsequently, similar discrepancies between laboratory evidence and the clinical state of hypoglycemia were described by many investigators in various types of experimental and clinical hypoglycemic states (4, 5, 6, 18–21).…”

Section: Discussionmentioning

confidence: 99%

“…On several occasions he found values between 110 and 394 mg per 100 ml. Harrop in 1937 (5) reported blood sugar values between 110 and 150 mg per 100 ml in 4 patients with insulin reactions.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pseudohypoglycemic Reactions in Insulin‐treated Diabetics: Etiology, Laboratory Aids and Therapy*

Fabrykant

1964

J American Geriatrics Society

View full text Add to dashboard Cite

“…Shortly after his discovery of insulin, Banting and his collaborators observed that in diabetics given insulin the clinical symptoms of an insulin reaction may occur without depression of the blood sugar to a subnormal level (1–3). Subsequently others found that the symptoms of an insulin reaction may develop even with a high blood sugar level (4, 5).…”

mentioning

confidence: 99%

Pseudohypoglycemic Reactions in Insulin‐treated Diabetics: Etiology, Laboratory Aids and Therapy*

Fabrykant

1964

J American Geriatrics Society

View full text Add to dashboard Cite

Shortly after his discovery of insulin, Banting and his collaborators observed that in diabetics given insulin the clinical symptoms of an insulin reaction may occur without depression of the blood sugar to a subnormal level (1-3). Subsequently others found that the symptoms of an insulin reaction may develop even with a high blood sugar level (4, 5).In the past twenty years we and others have noted that many patients with labile diabetes who are subject to episodes that clinically resemble hypoglycemic reactions, exhibit abnormalities in the electroactivity of the brain. Moreover, these reactions are not associated with hypoglycemia, and fail to respond to carbohydrate administration though they may be prevented or minimized by anticonvulsive therapy (6-10). For these reasons we have proposed the term "pseudohypoglycemic reaction" to designate the clinical symptoms that resemble those of an insulin reaction (in both labile and stable diabetes) but develop in the absence of a critically low blood sugar level (6-8). The occurrence of pseudohypoglycemic reactions was later reported in association with : (a) clinical disorders which can interfere with the normal function of the central nervous system, e.g., cerebral arteriosclerosis, and (b) clinical disorders accompanied by symptoms simiiar to those of hypoglycemia, e.g., the hypocalcemia of hypoparathyroidism (6,(11)(12)(13)(14)(15)(16).It is the purpose of this paper to stress the value of electroencephalographic studies in patients with pseudohypoglycemic reactions and unpredictable insulin reactions, and the importance of differential diagnosis. CLINICAL MATERIAL AND METHODSThe study was carried out on 122 patients with labile diabetes and 89 patients with stable diabetes, all 211 of whom were subject to frequent or unpredictable insulinreactions.Electroencephalographic records were obtained routinely in all cases. To avoid the effect of subnormal blood glucose levels, the EEG tracings were taken one or two hours after a normal meal. Both a resting record and a record after two minutes of hyperventilation were obtained. The electroencephalograms were repeated in most patients within six months to four years.Since many of the manifestations of parathyroid insufficiency and hypocalcemia may mimic those of hypoglycemia (14), serum calcium determinations were made routinely

show abstract

Hypoglycemia and the Toxic Effects of Insulin

Cited by 15 publications

References 6 publications

Hypoglycaemic symptoms reported by children with Type 1 diabetes mellitus and by their parents

Hypoglycaemic symptoms reported by children with Type 1 diabetes mellitus and by their parents

Pseudohypoglycemic Reactions in Insulin‐treated Diabetics: Etiology, Laboratory Aids and Therapy*

Pseudohypoglycemic Reactions in Insulin‐treated Diabetics: Etiology, Laboratory Aids and Therapy*

Contact Info

Product

Resources

About