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Hypoglycemic Unawareness: Challenges, Triggers, and Recommendations in Patients With Hypoglycemic Unawareness: A Case Report Publisher Pubmed



Sharifi Y1, 2 ; Ebrahimpur M3 ; Tamehrizadeh SS4
Authors
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Authors Affiliations
  1. 1. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, First Floor, No 10, Jalal-Al-Ahmad Street, North Kargar Avenue, Tehran, 14117-13137, Iran
  2. 2. Radiology Department, Iran University of Medical Sciences, Tehran, Iran
  3. 3. Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Medical Case Reports Published:2022


Abstract

Background: Hypoglycemia is a fairly common complication in diabetic patients, particularly in those on insulin therapy. Hypoglycemia symptoms are classified into two types: autonomic and neuroglycopenic symptoms. If a person develops neuroglycopenic symptoms before the appearance of autonomic symptoms or is asymptomatic until blood sugar levels are very low, the patient will develop hypoglycemic unawareness (HU). Case presentation: A 25-year-old Iranian woman with HU presented with a severe hypoglycemic episode. This episode was characterized by loss of consciousness and focal neural deficits, which were unusual symptoms in the patient, who was a medical intern with type 1 diabetes and currently being treated with regular and NPH insulin. Conclusions: Hypoglycemia is a common complication in diabetic patients receiving oral or insulin therapy. A patient who is unaware of their condition may experience severe and potentially fatal episodes. These incidents can negatively affect their daily lives as well as their careers and jobs. Hypoglycemia-associated autonomic failure is a possible cause for patients with multiple episodes of severe hypoglycemia. IThe use of a continuous glucose monitoring device with an alarm, if available, can be an excellent option for these patients. © 2022, The Author(s).