Hyperglycemia and neurological outcome in patients with head injury

1991 ◽  
Vol 75 (4) ◽  
pp. 545-551 ◽  
Author(s):  
Arthur M. Lam ◽  
H. Richard Winn ◽  
Bruce F. Cullen ◽  
Nancy Sundling
Keyword(s):  
Head Injury ◽  
Glucose Level ◽  
Neurological Outcome ◽  
Vegetative State ◽  
Elevated Serum ◽  
Serum Glucose ◽  
Serum Glucose Level ◽  
Glucose Levels ◽  
Gcs Score ◽  
Injured Patients

✓ To examine the relationship between serum glucose and the outcome of patients suffering from head injury, the authors retrospectively reviewed the clinical course of 169 patients admitted for treatment to Harborview Medical Center (a regional trauma center). All patients underwent craniotomy for evacuation of intracranial hematoma and/or placement of a subarachnoid bolt for intracranial pressure monitoring under general anesthesia. Patients with a Glasgow Coma Scale (GCS) score of 8 or less had significantly higher serum glucose levels than patients with GCS scores of 12 to 15 (mean ± standard error of the mean 192 ± 7 mg/dl vs. 130 ± 8 mg/dl or 10.7 ± 0.4 mmol/liter vs. 7.2 ± 0.4 mmol/liter) (p < 0.0001). Patients who subsequently remained in a vegetative state or died had significantly higher glucose levels both on admission and postoperatively than patients who had good outcome or moderate disability (217 ± 12 mg/dl vs. 167 ± 6 mg/dl or 12.1 ± 0.7 mmol/liter vs. 9.3 ± 0.3 mmol/liter on admission, and 240 ± 16 mg/dl vs. 156 ± 5 mg/dl or 13.3 ± 0.9 mmol/liter vs. 8.9 ± 0.3 mmol/liter postoperatively) (p < 0.0001). Among the more severely injured patients (GCS score ≤ 8), a serum glucose level greater than 200 mg/dl (11.1 mmol/liter) postoperatively is associated with a significantly worse outcome (p < 0.01). The authors conclude that severely head-injured patients frequently develop hyperglycemia and the elevated serum glucose level may aggravate ischemic insults and worsen the neurological outcome in such patients.

scholarly journals Admission serum glucose level as a marker of outcome severe head injury patients

2020 ◽  
Vol 4 (4) ◽  
pp. 209-211
Author(s):  
Bhagwati Salgotra ◽  
Raghavendra Nayak ◽  
Dhruv N. Patel ◽  
Marci Juneja ◽  
Deval Patel
Keyword(s):  
Head Injury ◽  
Glucose Level ◽  
Severe Head Injury ◽  
Serum Glucose ◽  
Serum Glucose Level

scholarly journals Serum Glucose Level and Hemoglobin Concentration in Third Trimester of Pregnancy

2016 ◽  
Vol 10 (2) ◽  
pp. 67-70
Author(s):  
Sumaira Sufrin ◽  
Akhtarun Nessa ◽  
Md Tazul Islam
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Glucose Level ◽  
Hemoglobin Concentration ◽  
Serum Glucose ◽  
Serum Glucose Level ◽  
Control Group ◽  
Third Trimester ◽  
Cross Sectional ◽  
Altered Glucose

Background : Pregnancy is a state of physiological adaptations to accommodate the needs of the developing fetus. Elevated blood glucose during pregnancy could lead to gestational diabetes and anemia could cause intercurrent infection.Objective: To assess the serum glucose level & hemoglobin concentration in third trimester of pregnancy in order to find out the risk of gestational diabetes and physiological anemia.Method: This cross-sectional study was carried out in the Department of Physiology Mymensingh Medical College, Mymensingh, between the period of July, 2013 to June,2014. One hundred pregnant women in their third trimester of pregnancy aged 18-35years were enrolled in study group and age matched 100 healthy non-pregnant women were control group. Random serum glucose was estimated by GOD-PAP method and hemoglobin concentration was measured by cyanmethemoglobin (CMG) method. Data were analyzed by student’s un paired t test and chi square test.Result: Mean serum glucose level (6.76±1.72 mmol/L) was significantly higher and hemoglobin concentration (8.21±1.23 g/dl) was significantly lower in pregnant women than non-pregnant women. Increased frequency of high glucose (38%) and low H b(88%) was found in pregnant women in third trimester.Conclusion: This study concludes altered glucose metabolism may lead to gestational diabetes as well as physiological anemia may be exaggerated in third trimester of pregnancyBangladesh Soc Physiol. 2015, December; 10(2): 67-70

Hypothalamic noradrenergic and sympathoadrenal control of glycemia after stress

1989 ◽  
Vol 256 (2) ◽  
pp. E231-E235
Author(s):  
G. A. Smythe ◽  
W. S. Pascoe ◽  
L. H. Storlien
Keyword(s):  
Insulin Release ◽  
Acute Stress ◽  
Serum Insulin ◽  
Elevated Serum ◽  
Serum Glucose ◽  
Neural Pathways ◽  
Swim Stress ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Positive Correlations

Central noradrenergic pathways play a significant role in mediating blood glucose levels after neuroglycopenia. To further investigate hypothalamic noradrenergic neuronal activity (NNA) and sympathoadrenal influences in glucoregulation, we studied the effects of acute stress on glycemia and insulin release in normal and adrenalectomized (ADRX) rats. Within 5 min of exposure of rats to ether or cold-swim stress, significant positive correlations were evident between hypothalamic NNA and serum glucose levels (r = 0.70, P less than 0.001; at 15 min r = 0.78, P less than 0.0001). Five minutes after stress in the intact rat, insulin release was inhibited and serum insulin levels inversely correlated to hypothalamic NNA (r = 0.45, P less than 0.05). This relationship between insulin and NNA was no longer present 15 min after stress, but the levels of insulin remained inappropriately low with respect to the elevated serum glucose levels (approximately 30% above basal). Blockade of sympathetic noradrenergic pathways by treatment of intact rats with guanethidine prevented the rise in glucose after cold-swim stress but did not prevent the inhibition of insulin release. Fifteen minutes after exposure of ADRX rats to cold-swim stress their hypothalamic NNA and serum glucose levels were similar to intact animals. However, in contrast to their intact counterparts, serum insulin levels were significantly elevated (P less than 0.01). These data are consistent with central noradrenergic neural pathways directly mediating hepatic glucose release and indirectly inhibiting pancreatic insulin release via activation of adrenal medullary catecholamines.

The N-terminal alanine-extended GLP-1/IgG-Fc fusion protein confers resistance to DPP-IV and reduces serum glucose level in db/db mice

2011 ◽  
Vol 170 (1-3) ◽  
pp. 1-3 ◽  
Author(s):  
Hye-Shin Chung ◽  
Ji-Yeon Oh ◽  
Seung-Bum Yoo ◽  
Sang Mee Lee ◽  
Heung-Soo Cho
Keyword(s):  
Fusion Protein ◽  
Glucose Level ◽  
Serum Glucose ◽  
Serum Glucose Level ◽  
Dpp Iv ◽  
Fc Fusion Protein

The effect of total parenteral nutrition on vasogenic edema development following cold injury in rats

1989 ◽  
Vol 70 (4) ◽  
pp. 623-627 ◽  
Author(s):  
David J. Combs ◽  
Linda Ott ◽  
Pamela S. McAninch ◽  
Robert J. Dempsey ◽  
Byron Young
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Glucose Level ◽  
Vasogenic Edema ◽  
Serum Glucose ◽  
Serum Osmolality ◽  
Cold Injury ◽  
Serum Glucose Level ◽  
Content Type ◽  
Fine Print

✓ Total parenteral nutrition (TPN) has been shown to decrease mortality and to increase the rate of recovery in head-injured patients. However, a recent short-term animal experiment has raised concern over the potential enhancement of vasogenic edema by TPN. The experiment described here was undertaken to examine longer-term effects of TPN infusion on vasogenic edema development. Twenty-four rats received an infusion of a TPN solution (35% glucose) or 0.9% saline at 4 ml/kg/hr for 4 or 26 hours following cold injury. In the 4-hour experiment, TPN increased the serum glucose level to 772 ± 57 mg/dl compared to 160 ± 14 mg/dl in the saline-treated animals (p = 0.0001) and increased serum osmolality to 312 ± 3 mOsm/kg compared to 291 ± 3 mOsm/kg in the saline-treated group (p = 0.0006). In the 26-hour experiment, TPN-infused rats were also hyperglycemic and hyperosmotic by 4 hours postinjury and remained hyperglycemic at 26 hours postinjury (serum glucose level 374 ± 97 mg/dl compared to 141 ± 3 mg/dl in saline-treated animals; p = 0.0371). Although by 26 hours the TPN-infused rats appeared hyperosmotic compared to the saline-treated rats, high variability in the TPN group prevented statistical confirmation of this observation (serum osmolality 337 ± 35 mOsm/kg in the TPN group compared to 287 ± 6 mOsm/kg in the saline group). A three-way analysis of variance with repeated measures was used to analyze the effect of infusion (saline vs. TPN), time (4 vs. 26 hours), and cold injury on the specific gravity of the five brain regions studied. Cold injury significantly increased edema development in the injured versus uninjured hemisphere for every region studied (p ≤ 0.0034, all five regions), and edema development increased significantly between 4 and 26 hours in three of the five regions (p ≤ 0.0207, all three regions). The infusion fluid was not a significant factor in any of the analyses. In conclusion, TPN infusion produced hyperglycemia and hyperosmolality in cold-injured rats but did not enhance vasogenic edema development in any brain region studied.

Effects of Fluid Therapy on Serum Glucose Level in Pediatric Outpatients

2006 ◽  
Vol 50 (2) ◽  
pp. 158 ◽  
Author(s):  
In Young Huh ◽  
Chong Hwa Baek ◽  
Jae Do Lee ◽  
Jin Woo Shin ◽  
Mi Jeung Gwak
Keyword(s):  
Glucose Level ◽  
Fluid Therapy ◽  
Serum Glucose ◽  
Serum Glucose Level ◽  
Pediatric Outpatients

scholarly journals Hypoglycaemic Property of Nutraceuticals

1970 ◽  
Vol 6 (2) ◽  
pp. 105-107
Author(s):  
Mohammad Emdadul Haque ◽  
Quazi Safayetullah ◽  
Monira Ahsan ◽  
Sheikh Nazrul Islam
Keyword(s):  
Glucose Level ◽  
Day Treatment ◽  
Positive Control ◽  
Serum Glucose ◽  
Negative Control ◽  
Diabetic Rats ◽  
Serum Glucose Level ◽  
Diabetic Rat ◽  
Black Cumin ◽  
Control Serum

Hypoglycemic property of four nutraceuticals named - black cumin, garlic, methi and karela has been investigated on an alloxan induced diabetic rat model. Glibenclamide was used as positive control and normal saline was used as negative control. Serum glucose levels of normal and diabetic induced rats were estimated by Glucose Oxidase method using a kit, and it were 4.33 ± 0.43 mmol/L and 8.27 ± 0.45mmol/L respectively. The alloxan induced diabetic rats were grouped into six, which were then treated with the four nutraceuticals and two controls. Treatment was given orally everyday for 28 days. Serum glucose level was analysed every 7 day intervals. It was observed that lowering of glucose level was significant (P = 0.01) for every 7 day treatment period. All of the nutraceuticals reduced the serum glucose level nearly to the normal value within 28 days. The rate of lowering of the glucose level was found to vary with the nutraceuticals. Garlic was found to be most active like the glibenclamide. The next active one was black cumin followed by methi and karela. The study conclude that nutraceuticals possess significant hypoglycemic property. Key words: Hypoglycaemia; Nutraceuticals; Black cumin; Garlic; Methi; Karela. Dhaka Univ. J. Pharm. Sci. 6(2): 105-107, 2007 (December)

scholarly journals Blood Glucose Levels May Aid the Decision for CT Scan in Minor Head Trauma

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
George A. Alexiou ◽  
Athanasios Sotiropoulos ◽  
Georgios D. Lianos ◽  
Andreas Zigouris ◽  
Dimitrios Metaxas ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Level ◽  
Head Trauma ◽  
Serum Glucose ◽  
Common Mechanism ◽  
Roc Curve Analysis ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Ct Findings ◽  
Mechanism Of Trauma

Traumatic brain injury has been associated with increased blood glucose levels. In the present study, we set out to investigate if blood glucose level in mild head trauma could predict the need for CT. One hundred fifty-nine patients with minor TBI (GCS 13-15) and a mean age of44.8±23.8years were included in the study. The most common mechanism of trauma was falls. Patients with positive CT findings had significantly higher glucose levels than patients with negative CT findings. Using ROC curve analysis, serum glucose levels higher than 120 mg dl-1were the optimal cutoff value for the detection of patients with positive CT findings with a sensitivity of 74.4% and a specificity of 90.7%. Serum glucose level evaluation at presentation in the emergency department may aid CT decision-making in mild TBI.

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