Severe Hypoglycemia and Type I Diabetes With Isolated ACTH Deficiency

Diabetes Care ◽  
1995 ◽  
Vol 18 (12) ◽  
pp. 1621-1622 ◽  
Author(s):  
N. Sakane ◽  
T. Yoshida ◽  
K. Yoshioka ◽  
T. Umekawa ◽  
M. Kondo
Keyword(s):  
Type I Diabetes ◽  
Severe Hypoglycemia ◽  
Type I ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency

Development of isolated ACTH deficiency in a man with type I diabetes mellitus

1988 ◽  
Vol 11 (5) ◽  
pp. 375-377 ◽  
Author(s):  
Andrea Giustina ◽  
R. Candrina ◽  
A. Cimino ◽  
G. Romanelli
Keyword(s):  
Diabetes Mellitus ◽  
Type I Diabetes ◽  
Type I Diabetes Mellitus ◽  
Type I ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency

scholarly journals Severe Hypoglycemia due to Isolated ACTH Deficiency in Children: A New Case Report and Review of the Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Michael Y. Torchinsky ◽  
Robert Wineman ◽  
George W. Moll
Keyword(s):  
Severe Hypoglycemia ◽  
Hormone Deficiency ◽  
Published Data ◽  
Pituitary Hormone ◽  
Review Of The Literature ◽  
Older Children ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency ◽  
Undetectable Plasma ◽  
Before And After

Isolated ACTH deficiency causes life-threatening severe hypoglycemia. A 7-year-old girl with hypoglycemia due to this rare disorder is described. Our patient had undetectable plasma ACTH repeatedly and cortisol 0 mcg/dl before and after ACTH 1-24 stimulation. There was no evidence of other pituitary hormone deficiency. Glucocorticoid replacement therapy resulted in resolution of all symptoms and normalization of blood glucose. Previously published data on isolated ACTH deficiency in children is summarized. Review of the literature showed that the prevalence of this condition could be underestimated in the neonatal period and in Prader-Willi syndrome. Isolated ACTH deficiency occurs in older children as well as in neonates.

Predictors of Ketoacidosis and Severe Hypoglycemia in Type I Diabetes

2002 ◽  
Vol 8 (1) ◽  
pp. 3-4
Author(s):  
C. Foster ◽  
S. L. Bratton
Keyword(s):  
Type I Diabetes ◽  
Severe Hypoglycemia ◽  
Type I

Association between Regional Cerebral Blood Flow during Hypoglycemia and Genetic and Phenotypic Traits of the Renin–Angiotensin System

2009 ◽  
Vol 29 (11) ◽  
pp. 1790-1795
Author(s):  
Lise Grimmeshave Bie-Olsen ◽  
Ulrik Pedersen-Bjergaard ◽  
Troels Wesenberg Kjær ◽  
Markus Nowak Lonsdale ◽  
Ian Law ◽  
...  
Keyword(s):  
Type I Diabetes ◽  
Renin Angiotensin System ◽  
Severe Hypoglycemia ◽  
Parahippocampal Gyrus ◽  
Phenotypic Traits ◽  
Type I ◽  
Angiotensin System ◽  
Healthy Men ◽  
Renin Angiotensin ◽  
Cerebral Activity

The risk of severe hypoglycemia in patients with type I diabetes and high basal activity in the renin–angiotensin system (RAS) is significantly higher than in patients with low basal RAS activity. In healthy men, we tested the hypothesis that differences in spontaneous RAS activity are associated with differences in cerebral activity responses during mild hypoglycemia. A total of 10 healthy men with high and 10 with low spontaneous RAS activity were selected. An H215O-PET (H215O-positron emission tomography) study was conducted with a series of six scans, i.e., two during normoglycemia, two during hypoglycemia, and two after hypoglycemia. The mean plasma glucose concentration was similar in both the groups (i.e., 2.1 mmol/L (s.d.: 0.4) in the low RAS group and 2.2 mmol/L (s.d.: 0.4) in the high RAS group ( P=0.47)). The high RAS group has lower cerebral activity in the frontal area and a higher cerebral activity in the entorhinal area that expanded to include the parahippocampal gyrus after hypoglycemia. Our findings suggest that the high RAS group to a lesser extent than the low RAS group activates areas involving executive function that may explain the correlation between high basal RAS activity and risk of severe hypoglycemia in type I diabetes.

scholarly journals HYPOGLYCEMIA AS INITIAL PRESENTATION IN PATIENT WITH ISOLATED ACTH DEFICIENCY

2020 ◽  
Vol 6 (6) ◽  
pp. e338-e341
Author(s):  
Fatimah Mohammed Alabdrabalnabi ◽  
Zahra Abdulwahed AL Saeed ◽  
Yasir Abuelgasim Elamin
Keyword(s):  
Adrenocorticotropic Hormone ◽  
Rare Condition ◽  
Severe Hypoglycemia ◽  
Tolerance Test ◽  
Pituitary Hormones ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency ◽  
Imaging Results ◽  
Life Threatening ◽  
Pituitary Antibodies

Objective: Isolated adrenocorticotropic hormone (ACTH) deficiency is characterized by loss of adrenocorticotropic hormone, resulting in adrenal insufficiency, which can lead to life threatening severe hypoglycemia. We report a case of isolated ACTH deficiency with emphases on presentation, common etiologies, diagnosis, and management. Methods: The clinical course in addition to laboratory and imaging results are presented. These include cortisol level, ACTH, other pituitary hormones, insulin tolerance test, pituitary antibodies, and pituitary magnetic resonance imaging. Results: A 19-year-old male was brought by ambulance to the emergency department with loss of consciousness and a random blood sugar of 30 mg/dL. Our patient had a barely detectable level of plasma ACTH repeatedly and cortisol <1 μg/dL. There was no involvement of other pituitary hormones. Steroid replacement therapy led to resolution of all symptoms and prevented further episodes of hypoglycemia. Conclusion: Isolated ACTH deficiency is a rare condition that is challenging to diagnose and can lead to serious life-threatening problems if unrecognized. Proper management can be achieved with appropriate hydrocortisone supplementation to mimic the normal secretion under both normal conditions and during a state of stress.

scholarly journals A CASE OF ISOLATED ACTH DEFICIENCY WITH SEVERE HYPOGLYCEMIA

2013 ◽  
Vol 59 (6) ◽  
pp. 502-506
Author(s):  
HAJIME M. KOYANO ◽  
JUNKO SATO ◽  
SHOUKO YOSHII ◽  
YOSHIE KOIKE
Keyword(s):  
Severe Hypoglycemia ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency
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