Hypothermia as a forgotten sign of prolonged severe hypoglycaemia

Naseerullah, Fahad Syed; Murthy, Avinash

doi:10.1136/bcr-2018-225606

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Only after correction of his blood glucose did his hypothermia and diaphoresis improve. This case report indicated that hypothermia has previously been documented as an adaptive neuroprotective mechanism in people with acute hypoglycemia [ 7 ]. This case shares many similarities with our patient’s presentation of Shapiro syndrome: resistant hypothermia and diaphoresis.…”

Section: Discussionmentioning

confidence: 98%

Hypoglycemia as a Manifestation of Shapiro Syndrome

Lewis¹,

Freeman²,

Gupta³

2022

Cureus

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Shapiro syndrome is an extremely rare disorder of dysautonomia characterized by paroxysmal episodic hypothermia to below 95°F. Many patients with Shapiro syndrome improve with medical management, though a minority of cases are refractory to treatment. Our patient with adult-onset Shapiro syndrome is an atypical case. Our patient has been refractory to medical treatment as well as chemical sympathectomy. Based on a review of the literature, this is also the first reported case of hypoglycemia with Shapiro syndrome episodes in the absence of other metabolic diseases. This case suggests that hypoglycemia could be a potential manifestation of Shapiro syndrome.

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Section: Discussionmentioning

confidence: 98%

Hypoglycemia as a Manifestation of Shapiro Syndrome

Lewis¹,

Freeman²,

Gupta³

2022

Cureus

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“…In the present study, pigs with a blood glucose concentration less than 70 mg/dL had increased mortality as body temperature at removal increased. Throughout the literature hypoglycemia has been observed in combination with both hypo and hyperthermia ( Chochinoz and Daughaday, 1975 ; Tran et al, 2012 ; Naseerullah and Murthy, 2018 ), although hypothermia is generally associated with severe hypoglycemia rather than hyperglycemia. Pigs with a blood glucose concentration greater than or equal to 70 mg/dL had decreased mortality as body temperature increased.…”

Section: Discussionmentioning

confidence: 99%

Effects of gruel feeding and oral dextrose on the survivability of pigs after weaning

Wensley

Boschert

et al. 2023

Translational Animal Science

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Two experiments were conducted in a 14,400 head nursery using 3,087 (Exp. 1) and 988 (Exp. 2) pigs to determine the effect of gruel feeding (Exp. 1) and supplemental oral dextrose (Exp. 2) on nursery pig survivability after weaning. Upon arrival to the nursery, for Exp. 1, the smallest 10% of pigs were selected and randomly placed in pens with 61 to 108 pigs per pen. Pens of small pigs were assigned to 1 of 2 treatments in a completely randomized design. Treatments consisted of gruel feeding two or four times per day for 14-d post-placement. At each gruel feeding, approximately 1.13 kg of solid feed was added to a round bowl (Rotecna S.A., Agramunt, Spain) located at the front of each pen and water added at a decreasing rate over time. In Exp. 2, every other pig removed for welfare considerations (lameness, sick, or unthrifty) from the general population or pens of small pigs received a single 10 mL oral dose of a 50% dextrose solution (Vet One, MWI Animal Health, Boise, ID), as a source of glucose, before being placed in a removal pen. All removed pigs were tagged and weighed, body temperature recorded, and blood glucose concentration measured prior to and 30 min after entering removal pens. Overall, gruel feeding small pigs two or four times per day for 14-d post-placement did not influence (P > 0.10) mortality from weaning to the end of gruel feeding (3.78 vs 4.25%, respectively). Likewise, dextrose administration did not influence (P > 0.10) pig mortality after removal to approximately 38 d post-weaning (21.4 vs 23.4% respectively), even though blood glucose concentration increased (P < 0.001) 30 min after removal for pigs administered dextrose. An interaction was observed for blood glucose concentration and body temperature (P < 0.001) where pigs with blood glucose concentrations less than 70 mg/dL had increased mortality as body temperature increased. In contrast, pigs with a blood glucose concentration of 70 mg/dL or greater had decreased mortality as body temperature increased. Pigs weighing less than 4.5 kg also had increased mortality (P < 0.001) compared with pigs weighing greater than or equal to 4.5 kg at removal. In summary, gruel feeding four times per day vs two times per day or providing a dextrose supplement to pigs removed from the general population did not improve the survivability of pigs after weaning. Additionally, pigs removed with decreased body weight or with body temperature or blood glucose concentrations below or above the normal range had decreased survivability.

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“…In humans, there is some evidence linking hypothermia to hypoglycemic events in patients with diabetes (Naseerullah and Murthy 2018 ; Tran et al 2012 ). In many small mammals, hypoglycemia and the fall of blood glucose levels are associated with the initiation of spontaneous torpor or hibernation and a hypometabolic state characterized by a reduction in body temperature and activity (Atgie et al 1990 ; Dark et al 1999 ; Lo Martire et al 2018 ).…”

Section: Discussionmentioning

confidence: 99%

In vivo cardiopulmonary impact of skeletal M3Dq DREADD expression: a pilot study

Vincent

Fisher

2021

J Comp Physiol B

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The muscarinic M3 receptor (M3R) is implicated in cardiopulmonary control and many other peripheral physiologic functions. Previous observations report mortality in mice expressing a Gq-linked designer G-protein coupled receptor (Dq) selectively in striated muscle, while M3Dq DREADD (Designer Receptor Exclusively Activated by Designer Drug), selectively expressed in skeletal muscle (SKM) impacts glucose metabolism. We investigated whether activation of SKM M3Dq impacts cardiopulmonary function. Heart rate (HR), body temperature (Tb) and locomotor activity (ACT) were measured in 4 conscious, chronically instrumented M3Dq DREADD mice and 4 wildtype controls. Circadian values of HR, BT and ACT were not different between genotypes (p > 0.05). Activation of the M3Dq DREADD by clozapine N-oxide (CNO; 0.1 mg/kg) resulted in: a significant drop in heart rate, 2 h after injection, compared with a time-matched baseline control period from the same animals (460 ± 28 vs. 532 ± 6, p < 0.05), significantly lower ACT compared to the baseline control (p < 0.05) and reduced pulmonary minute ventilation compared to pre-CNO control (p < 0.05). M3Dq DREADD activation did not cause bronchoconstriction (separate protocol), however, there was a concomitant reduction in HR, Tb and ventilation, accompanied by cardiac arrhythmias. We speculate that reductions in Tb, HR and ventilation reflect a mechanistic link between SKM Gq signaling and the metabolic responses associated with the initiation of torpor. Supported by the Canadian Institutes of Health Research (CIHR MOP-81211).

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Hypothermia as a forgotten sign of prolonged severe hypoglycaemia

Cited by 4 publications

References 6 publications

Hypoglycemia as a Manifestation of Shapiro Syndrome

Hypoglycemia as a Manifestation of Shapiro Syndrome

Effects of gruel feeding and oral dextrose on the survivability of pigs after weaning

In vivo cardiopulmonary impact of skeletal M3Dq DREADD expression: a pilot study

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