scholarly journals Cotrimoxazole-Induced Hypoglycemia in an HIV-Infected Patient

2001 ◽  
Vol 12 (5) ◽  
pp. 314-316 ◽  
Author(s):  
Christine A Hughes ◽  
Constance L Chik ◽  
Geoffrey D Taylor
Keyword(s):  
Risk Factors ◽  
Blood Glucose ◽  
Male Patient ◽  
Infected Patient ◽  
Pneumocystis Carinii ◽  
High Dose ◽  
Intravenous Bolus ◽  
C Peptide ◽  
Glucose Levels ◽  
Blood Glucose Levels

A case of cotrimoxazole-induced hypoglycemia is described in a male patient infected with HIV. Ten days after initiating high dose cotrimoxazole for suspectedPneumocystis cariniipneumonia, the patient developed neuroglycopenic symptoms and diaphoresis. Blood glucose levels were repeatedly low, with elevated insulin and C-peptide levels despite multiple intravenous bolus doses and infusions of dextrose. Hypoglycemia resolved after approximately 36 h of treatment with dextrose and discontinuation of cotrimoxazole. A review of reported cases of hypoglycemia associated with cotrimoxazole is provided, including information about onset, risk factors and possible mechanism.

Streptozotocin-induced diabetes differentially affects sympathetic innervation and control of plantar metatarsal and mesenteric arteries in the rat

2013 ◽  
Vol 304 (2) ◽  
pp. H215-H228 ◽  
Author(s):  
Niloufer J. Johansen ◽  
Diana Tripovic ◽  
James A. Brock
Keyword(s):  
Blood Glucose ◽  
Vascular Function ◽  
Neural Control ◽  
Sympathetic Innervation ◽  
Nerve Fibers ◽  
Transmural Pressure ◽  
Mesenteric Arteries ◽  
High Dose ◽  
Glucose Levels ◽  
Blood Glucose Levels

In humans neural control of arterial vessels supplying skin in the extremities is particularly vulnerable to the effects of diabetes. Here the streptozotocin (STZ) rat model of type 1 diabetes was used to compare effects on neurovascular function in plantar metatarsal arteries (PMAs), which supply blood to skin of hind paw digits, with those in mesenteric arteries (MAs). Twelve weeks after STZ (60 mg/kg ip), wire myography was used to assess vascular function. In PMAs, lumen dimensions were unchanged but both nerve-evoked contractions and sensitivity to α1 (phenylephrine, methoxamine)- and α2 (clonidine)-adrenoceptor agonists were reduced. The density of perivascular nerve fibers was also reduced by ∼25%. These changes were not observed in PMAs from STZ-treated rats receiving either a low dose of insulin that did not greatly reduce blood glucose levels or a high dose of insulin that markedly reduced blood glucose levels. In MAs from STZ-treated rats, nerve-evoked increases in force did not differ from control but, because lumen dimensions were ∼20% larger, nerve-evoked increases in effective transmural pressure were smaller. Increases in effective transmural pressure produced by phenylephrine or α,β-methylene ATP in MAs from STZ-treated rats were not smaller than control, but the density of perivascular nerve fibers was reduced by ∼10%. In MAs, the increase in vascular dimensions is primarily responsible for reducing effectiveness of nerve-evoked constrictions. By contrast, in PMAs decreases in both the density of perivascular nerve fibers and the reactivity of the vascular muscle appear to explain impairment of neurovascular transmission.

Partial protection against streptozotocin-induced hyperglycaemia by superoxide dismutase linked to polyethylene glycol

1984 ◽  
Vol 107 (3) ◽  
pp. 390-394 ◽  
Author(s):  
kjell Asplund ◽  
Kjell Grankvist ◽  
Stefan Marklund ◽  
Inge-Bert Täljedal
Keyword(s):  
Superoxide Dismutase ◽  
Polyethylene Glycol ◽  
Blood Glucose ◽  
Superoxide Radicals ◽  
High Dose ◽  
Partial Protection ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Pre Treatment

Abstract. To test the possible role of superoxide radicals in the diabetogenic action of streptozotocin, blood glucose levels were measured in mice after a single high-dose (150 mg/kg body weight) or multiple low-dose (40 mg/kg for 5 days) injections of streptozotocin. Pre-treatment 6 h before streptozotocin with 250–300 mg/kg superoxide dismutase coupled to polyethylene glycol reduced the hyperglycaemic response in mice injected with a single dose of streptozotocin. The blood glucose levels after multiple low doses of streptozotocin were not affected by superoxide dismutase-polvethvlene glycol. Enzymatically inactive superoxide dismutase did not affect the development of hyperglycaemia. The results suggest that superoxide radicals may play a role in the diabetogenic action of streptozotocin injected as a high-dose single bolus.

scholarly journals Risk factors for acute kidney injury and mortality in high risk patients undergoing cardiac surgery

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252209
Author(s):  
Giuseppe Filiberto Serraino ◽  
Michele Provenzano ◽  
Federica Jiritano ◽  
Ashour Michael ◽  
Nicola Ielapi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Blood Glucose ◽  
Kidney Injury ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Risk Patients

Background Acute Kidney Injury (AKI) represents a clinical condition with poor prognosis. The incidence of AKI in hospitalized patients was about 22–57%. Patients undergoing cardiac surgery (CS) are particularly exposed to AKI because of the related oxidative stress, inflammation and ischemia-reperfusion damage. Hence, the risk profile of patients undergoing CS who develop AKI and who are consequently at increased mortality risk deserves further investigation. Methods We designed a retrospective study examining consecutive patients undergoing any type of open-heart surgery from January to December 2018. Patients with a history of AKI were excluded. AKI was diagnosed according to KDIGO criteria. Univariate associations between clinical variables and AKI were tested using logistic regression analysis. Variable thresholds maximizing the association with AKI were measured with the Youden index. Multivariable logistic regression analysis was performed to assess predictors of AKI through backward selection. Mortality risk factors were assessed through the Cox proportional hazard model. Results We studied 158 patients (mean age 51.2±9.7 years) of which 74.7% were males. Types of procedures performed were: isolated coronary artery bypass (CABG, 50.6%), valve (28.5%), aortic (3.2%) and combined (17.7%) surgery. Overall, incidence of AKI was 34.2%. At multivariable analysis, young age (p = 0.016), low blood glucose levels (p = 0.028), estimated Glomerular Filtration Rate (p = 0.007), pH (p = 0.008), type of intervention (p = 0.031), prolonged extracorporeal circulation (ECC, p = 0.028) and cross-clamp (p = 0.021) times were associated with AKI. The threshold for detecting AKI were 91 and 51 minutes for ECC and cross-clamp times, respectively. At survival analysis, the presence of AKI, prolonged ECC and cross-clamp times, and low blood glucose levels forecasted mortality. Conclusions AKI is common among CS patients and associates with shortened life-expectancy. Several pre-operative and intra-operative predictors are associated with AKI and future mortality. Future studies, aiming at improving prognosis in high-risk patients, by a stricter control of these factors, are awaited.

scholarly journals Blood Glucose Changes during Neurosurgery

1979 ◽  
Vol 7 (1) ◽  
pp. 45-49
Author(s):  
Christopher G. Male
Keyword(s):  
Blood Glucose ◽  
Family History ◽  
Body Temperature ◽  
Older Patients ◽  
High Dose ◽  
Family History Of Diabetes ◽  
Induced Hypotension ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
History Of

Blood glucose levels were studied prospectively in 40 patients undergoing elective major craniotomy. A significant (p < 0.01) hyperglycaemic response was noted after scalp infiltration with adrenaline and incision (0.5 mmol/l) and with continued surgery (0.9 mmol/l). Patients aged 50 years and under showed a significantly greater rise with adrenaline and incision than older patients (0.8 compared with 0.4 mmol/l p < 0.01). Preoperative high dose steroid therapy did not modify the response Blood glucose changes were unrelated to sex, obesity, a family history of diabetes, the duration of starvation, intraoperative body temperature, anaesthetic technique induced hypotension or blood loss.

scholarly journals Insulin, C-peptide and proinsulin for the biochemical diagnosis of hypoglycaemia related to endogenous hyperinsulinism

2007 ◽  
Vol 157 (1) ◽  
pp. 75-83 ◽  
Author(s):  
D Vezzosi ◽  
A Bennet ◽  
J Fauvel ◽  
P Caron
Keyword(s):  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Diagnostic Specificity ◽  
C Peptide ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Specificity And Sensitivity ◽  
Obese Subjects ◽  
Best Parameters ◽  
Rule Out

Objective: We evaluated the respective value of insulin, C-peptide and proinsulin levels in 33 patients with endogenous hyperinsulinism and in 67 controls to determine the best parameters and thresholds to make or to rule out the diagnosis of endogenous hyperinsulinism. Results: When blood glucose levels were below 2.5 mmol/l, insulin was <21 pmol/l in 8–35% of the patients and in all controls; C-peptide was >0.2 nmol/l in all insulinomas but not in the nesidioblastosis or in the controls; proinsulin was >5 pmol/l in all patients but not in the controls. When fasting blood glucose levels reached 2.5–3.3 mmol/l, proinsulin was <22 pmol/l in all the controls and >22 pmol/l in 74% of the patients. Proinsulin after an overnight fast was below 22 pmol/l in all non-obese controls and above 22 pmol/l in 73% of non-obese patients. Conclusion: Proinsulin levels above 5 pmol/l with blood glucose levels below 2.5 mmol/l during a 72 h fast test represent the best criterion for the diagnosis of endogenous hyperinsulinism, reaching 100% diagnostic specificity and sensitivity. Concomitant C-peptide levels above 0.2 nmol/l also make the diagnosis of all our insulinoma patients, not the diagnosis of nesidioblastosis, while insulin levels have much less diagnostic accuracy. Whether proinsulin levels above 22 pmol/l could also make the diagnosis of endogenous hyperinsulinism in part of the patients at the time of fasting blood glucose levels between 2.5 and 3.3 mmol/l or after an overnight fast in non-obese subjects needs further study.

scholarly journals UJI EFEKTIVITAS ANTIDIABETES KOMBINASI EKSTRAK DAUN MENIRAN (Phyllanthus niruri L.) Dan KELOPAK BUNGA ROSELLA (Hibiscus sabdariffa L.) PADA TIKUS JANTAN PUTIH

2019 ◽  
Vol 2 (1) ◽  
pp. 24-28
Author(s):  
Herviani Sari ◽  
Vera Estefania Kaban ◽  
Friska Raulina Situmorang ◽  
Firdaus Fahdi
Keyword(s):  
Blood Glucose ◽  
Leaf Extract ◽  
Negative Control Group ◽  
Positive Control ◽  
Negative Control ◽  
Control Group ◽  
High Dose ◽  
Glucose Levels ◽  
White Rats ◽  
Blood Glucose Levels

Purpose: To determine the effect of decreasing blood glucose levels in white rats using a combination of meniran and rosella compared to glibenclamide. Method: This research was carried out experimentally. Simplicia of meniran leaves and rosella macerated using 80% ethanol. The research used 21 rats that were induced by alloxan and divided into 7 groups and all compared using glibenclamide.Group 1 (negative control) CMC Na 1%, group 2 (positive control) glibenclamide dose 0.45 mg/kgMB, group 3 single roselle extract dose 130 mg/kgMB, group 4 single meniran leaf extract dose 200 mg/kgMB, group 5 combination of meniran leaf extract dose of 100 mg/kgMB and rosella extract dose of 65 mg/kgMB, group 6 combination of meniran leaf extract dose of 200 mg/kgMB and rosella extract dose of 130 mg/kgMB, and group 7 meniran leaf extract combination dose 400 mg/kgMB and rosella extract dose 195 mg/kgMB. Result: The results showed that rats had hyperglycemia after being induced by alloxan.Data were analyzed using one way ANOVA method followed by LSD and tukeys' B post hoct test. Having a difference in the decrease in blood glucose levels between the positive control group and the five doses of meniran extract and rosella gave a significant effect compared to the negative control group did not have a significant effect in reducing blood glucose levels. Conclusion: Single meniran extract and high-dose combination extract are more effective than glibenclamide.

scholarly journals Evaluation of antidiabetic activity in Corallocarpus epigaeus rhizomes

2013 ◽  
Vol 2 (3) ◽  
pp. 53-56 ◽  
Author(s):  
Kattamanchi Gnananath ◽  
Kontham Ramakanth Reddy ◽  
Gudur Pavan Kumar ◽  
Bheemanapally Krishna ◽  
Karka Srinivas Reddy ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Plant Extract ◽  
Pharmacological Action ◽  
Pharmaceutical Journal ◽  
Antidiabetic Activity ◽  
High Dose ◽  
Time Interval ◽  
Time Intervals ◽  
Glucose Levels ◽  
Blood Glucose Levels

From these results it can be understood that plant extract showing its pharmacological action on diabetes between the time intervals of 1-2 hr after its administration. This is exactly what the action that is being observed from the standard Glibenclamide group which also shown its action at its 1-2 hr of administration to the animals. Here the statistically significant action of the higher dose of plant extract can be compared with that of the standard Glibenclamide group. From these results it can be understood that the plant extract is capable of inhibiting the elevation of blood glucose level to the extent of the action that has been shown by the standard Glibenclamide group. Particularly at the time interval of 2-4 hr both the Glibenclamide and plant extract at its high dose group that is 400 mg/kg has been significantly inhibited the elevation of the blood glucose levels in the animals.DOI: http://dx.doi.org/10.3329/icpj.v2i3.13581 International Current Pharmaceutical Journal, February 2013, 2(3): 53-56

UJI EFEKTIVITAS ANTIDIABETES KOMBINASI EKSTRAK DAUN MENIRAN (Phyllanthus niruri L.) dan KELOPAK BUNGA ROSELLA (Hibiscus sabdariffa L.) pada TIKUS JANTAN PUTIH SEBAGAI HEWAN PERCOBAAN

2019 ◽  
Vol 2 (1) ◽  
pp. 19-23
Author(s):  
Herviani Sari ◽  
Vera Estefania Kaban ◽  
Friska Raulina Situmorang ◽  
Firdaus Fahdi
Keyword(s):  
Blood Glucose ◽  
Leaf Extract ◽  
Negative Control Group ◽  
Positive Control ◽  
Negative Control ◽  
Control Group ◽  
High Dose ◽  
Glucose Levels ◽  
White Rats ◽  
Blood Glucose Levels

Background : Diabetes mellitus (DM) is a chronic disease caused by the body's inability to produce the hormone insulin or due to ineffective use of insulin production. Diabetes has become a global problem, DM prevalence of 4.6%, estimated in 2000 amounted to 5.6 million. One of the plants that can reduce blood glucose levels is meniran and rosella which are found in Indonesia. Objective : To determine the effect of decreasing blood glucose levels in white rats using a combination of meniran and rosella compared to glibenclamide.Method : This research was carried out experimentally. Simplicia of meniran leaves and rosella macerated using 80% ethanol. The research used 21 rats that were induced by alloxan and divided into 7 groups and all compared using glibenclamide.Group 1 (negative control) CMC Na 1%, group 2 (positive control) glibenclamide dose 0.45 mg / kgBB, group 3 single roselle extract dose 130 mg / kgBB, group 4 single meniran leaf extract dose 200 mg / kgBB, group 5 combination of meniran leaf extract dose of 100 mg / kgBB and rosella extract dose of 65 mg / kgBB, group 6 combination of meniran leaf extract dose of 200 mg / kgBB and rosella extract dose of 130 mg / kgBB, and group 7 meniran leaf extract combination dose 400 mg / kgBB and rosella extract dose 195 mg / kgBB. Result : The results showed that rats had hyperglycemia after being induced by alloxan.Data were analyzed using one way ANOVA method followed by LSD and tukeys' B post hoct test. Having a difference in the decrease in blood glucose levels between the positive control group and the five doses of meniran extract and rosella where p <0.05 gave a significant effect compared to the negative control group p> 0.05 did not have a significant effect in reducing blood glucose levels. Conclusion : Single meniran extract and high-dose combination extract are more effective than glibenclamide.

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