Kubiak T, Kuhr B, Inselmann D, Hermanns N, Kulzer B, Haak T
Research Institute of the Diabetes Academy Mergentheim, Bad Mergentheim, Germany.
Diabet Med. 2004 Dec;21(12):1366-7. doi: 10.1111/j.1464-5491.2004.01320.x.
A case of a male 34-year-old Type 1 diabetic patient who experienced a prolonged severe hypoglycaemic episode is presented. After the hypoglycaemic event, the patient suffered from moderate to severe neuropsychological impairments. On the basis of neuropsychological assessment results, diabetes therapy was modified (less complex insulin regimen, fixed insulin doses and fixed carbohydrate distribution). At a follow-up examination (3 months), presumable complete recovery of cognitive function was observed. This case demonstrates the possible detrimental neuropsychological effects of severe hypoglycaemia, that, in this case, turned out to be reversible. It highlights the clinical implications of impaired cognitive function on self-care and self-management abilities and the usefulness of neuropsychological testing in clinical diabetes care.
本文介绍了一例34岁1型糖尿病男性患者,该患者经历了一次长时间的严重低血糖发作。低血糖事件发生后,患者出现了中度至重度神经心理障碍。根据神经心理评估结果,调整了糖尿病治疗方案(采用较简单的胰岛素治疗方案、固定胰岛素剂量和固定碳水化合物分配)。在随访检查(3个月)时,观察到认知功能可能已完全恢复。该病例表明严重低血糖可能产生有害的神经心理影响,在本病例中这种影响被证明是可逆的。它突出了认知功能受损对自我护理和自我管理能力的临床意义,以及神经心理测试在临床糖尿病护理中的作用。