A 57-year-old woman presented with symptoms which were cured by the removal of an insulinoma. The case was atypical in that symptomatic hypoglycaemia occurred only after meals or glucose administration but never during fasting, and thus if plasma insulin activity had not been measured an incorrect diagnosis of reactive hypoglycaemia might have been made on the basis of symptoms and oral glucose...

1. The response of hand blood flow to acute insulin-induced hypoglycaemia was measured in normal subjects in whom vasomotor tone had been released physiologically by body heating, anatomically by unilateral nerve block and pharmacologically by unilateral intra-arterial infusion of bretylium tosylate or phenoxybenzamine. Five patients who had undergone unilateral cervical sympathectomy were also...

Hypoglycaemia is frequent in children and prompt management is required to prevent brain injury. In this article we will consider hypoglycaemia in children after the neonatal period. The most common causes are diabetes mellitus and idiopathic ketotic hypoglycaemia (IKH) but a number of endocrine disorders and inborn errors of metabolism (IEMs) need to be excluded. Elucidation of the diagnosis r...

It is almost a century since hypoglycaemia (a reduction in the glucose concentration of circulating blood) was first described in children, and over 50 years since the condition was first recognized in infants. Nevertheless, controversy still surrounds the definition, significance, and management of neonatal hypoglycaemia. Technological developments such as bedside glucose monitoring have, para...

One of the life threatening complications of diabetes is hypoglycaemia. It is a common complication, with times of greatest risk being before meals and during the night. Symptoms usually develop when the blood glucose level falls below 3.5 mmol/l. Many patients with long-standing diabetes report loss of warning symptoms. Prevention of such hypoglycaemic attacks is highly desirable. Recently a d...

1 Marks V, Teale JD. Investigation of hypoglycaemia. Clin Endocrinol 1996;44:133-6. 2 Teale JD, Blum WF, Marks V. Alleviation of non-islet cell tumour hypoglycaemia by growth hormone therapy is associated with changes in IGF binding protein-3. Ann Clin Biochem 1992;29:314-23. 3 Marks V, Teale JD. Tumours producing hypoglycaemia. Diabet Metab Rev 1991;7:79-91. 4 Teale JD, Marks V. Inappropriatel...

BACKGROUND Hypoglycaemia is an independent risk factor for death in severe malaria and a recognized adverse treatment effect of parenteral quinine. In 2006 our hospital changed quinine treatment policy from 15 mg/kg loading (plus 10 mg/kg 12-hourly) to 20 mg/kg loading (plus 10 mg/kg 8-hourly) to comply with new WHO guidelines. This presented us with the opportunity to examine whether there was...

Hypoglycaemia is a common side-effect of glucose-lowering therapies for type-2 diabetic patients, which may cause cognitive/neurological impairment. Although the effects of hypoglycaemia in the brain have been extensively studied in neurons, how hypoglycaemia impacts the viability of adult neural stem cells (NSCs) has been poorly investigated. In addition, the cellular and molecular mechanisms ...

Treat-to-target trial designs compare investigational insulins with a standard insulin. Treat-to-target trials force-titrate insulin dosages to achieve a prespecified treatment goal. With comparable glycaemic control, comparisons of safety endpoints such as hypoglycaemia can be made to establish the risk-benefit profile of the new insulin. Glargine versus NPH showed comparable A1C reductions; h...