Panchani Roopal, Goyal Ashutosh, Varma Tarun, Tripathi Sudhir
Department of Endocrinology, Sir Ganga Ram Hospital, New Delhi, India.
Indian J Endocrinol Metab. 2013 Oct;17(Suppl 1):S310-2. doi: 10.4103/2230-8210.119640.
Good control of plasma glucose levels always remains a desired goal for both diabetic patients and their physicians. However, unintended tight glucose control should always be alarming to the treating physician, although, it may seem to be a blessing to the patient. A downward trend in blood glucose profile in an elderly male with long standing diabetes generally points to developing renal insufficiency. Apart from that, other causes responsible for lowering of blood glucose have to be considered at times when clinical scenario is slightly different. Here, we present a case of an elderly man who presented with an unintended tight control of blood glucose over a period of few months, which upon neglecting culminated into recurrent hypoglycaemia. The etiology of recurrent hypoglycaemia in this patient was non-islet cell tumor hypoglycaemia (NICTH). The causes, pathophysiology, and management of NICTH are discussed briefly.
对糖尿病患者及其医生来说,良好控制血糖水平一直是一个理想目标。然而,意外的严格血糖控制对治疗医生来说应始终敲响警钟,尽管这对患者看似是一件好事。长期患糖尿病的老年男性血糖水平呈下降趋势,通常表明肾功能不全正在发展。除此之外,当临床情况略有不同时,有时必须考虑导致血糖降低的其他原因。在此,我们报告一例老年男性病例,该患者在几个月的时间里出现了意外的严格血糖控制,因被忽视最终导致反复低血糖。该患者反复低血糖的病因是非胰岛细胞瘤低血糖症(NICTH)。本文将简要讨论NICTH的病因、病理生理学及管理。