Hypoglycemic Emergencies

1992 ◽  
Vol 3 (2) ◽  
pp. 361-369
Author(s):  
Kathryn Mulcahy
Keyword(s):  
Optimal Control ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Warning Signs ◽  
Loss Of Consciousness ◽  
Carbohydrate Ingestion ◽  
Prompt Treatment ◽  
Simple Carbohydrate

Optimal control of blood glucose requires a balance of diet, exercise, and in some cases, medications. Many factors can cause a state of imbalance, resulting in extremes of glucose control. Hypoglycemia is defined generally as a blood glucose level lower than 50 mg/dL. Although the causes of hypoglycemic episodes are diverse, the management is always aimed at normalizing the plasma glucose concentration. Treatment ranges from simple carbohydrate ingestion in mild to moderate cases to intravenous administration of glucose when the reaction is severe and loss of consciousness occurs. Recognition of warning signs and prompt treatment is essential in all cases

scholarly journals Effects of carbohydrate ingestion before and during exercise on glucose kinetics and performance

2000 ◽  
Vol 89 (6) ◽  
pp. 2220-2226 ◽  
Author(s):  
Mark A. Febbraio ◽  
Alison Chiu ◽  
Damien J. Angus ◽  
Melissa J. Arkinstall ◽  
John A. Hawley
Keyword(s):  
Plasma Glucose ◽  
Glucose Concentration ◽  
Peak Power ◽  
Glucose Oxidation ◽  
Time Trial ◽  
Peak Power Output ◽  
Glucose Kinetics ◽  
Carbohydrate Ingestion ◽  
Total Fat ◽  
And Performance

We investigated the effect of carbohydrate (CHO) ingestion before and during exercise and in combination on glucose kinetics, metabolism and performance in seven trained men, who cycled for 120 min (SS) at ∼63% of peak power output, followed by a 7 kJ/kg body wt time trial (TT). On four separate occasions, subjects received either a placebo beverage before and during SS (PP); placebo 30 min before and 2 g/kg body wt of CHO in a 6.4% CHO solution throughout SS (PC); 2 g/kg body wt of CHO in a 25.7% CHO beverage 30 min before and placebo throughout SS (CP); or 2 g/kg body wt of CHO in a 25.7% CHO beverage 30 min before and 2 g/kg of CHO in a 6.4% CHO solution throughout SS (CC). Ingestion of CC and CP markedly (>8 mM) increased plasma glucose concentration ([glucose]) compared with PP and PC (5 mM). However, plasma [glucose] fell rapidly at the onset of SS so that after 80 min it was similar (6 mM) between all treatments. After this time, plasma [glucose] declined in both PP and CP ( P < 0.05) but was well maintained in both CC and PC. Ingestion of CC and CP increased rates of glucose appearance (Ra) and disappearance (Rd) compared with PP and PC at the onset of, and early during, SS ( P < 0.05). However, late in SS, both glucose Ra and Rd were higher in CC and PC compared with other trials ( P < 0.05). Although calculated rates of glucose oxidation were different when comparing the four trials ( P < 0.05), total CHO oxidation and total fat oxidation were similar. Despite this, TT was improved in CC and PC compared with PP ( P < 0.05). We conclude that 1) preexercise ingestion of CHO improves performance only when CHO ingestion is maintained throughout exercise, and 2) ingestion of CHO during 120 min of cycling improves subsequent TT performance.

Importance of blood glucose concentration in regulating lipolysis during fasting in humans

1990 ◽  
Vol 258 (1) ◽  
pp. E32-E39 ◽  
Author(s):  
S. Klein ◽  
O. B. Holland ◽  
R. R. Wolfe
Keyword(s):  
Blood Glucose ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Plasma Insulin ◽  
Blood Glucose Concentration ◽  
Glucose Infusion ◽  
Short Term ◽  
Epinephrine Infusion ◽  
Isotopic Studies ◽  
Fasting Plasma Insulin

The importance of the decline in blood glucose concentration on lipolysis and the lipolytic effect of epinephrine was evaluated during short-term fasting. Lipolytic rates were determined by infusing [2H5]glycerol and [1-13C]palmitic acid. Five volunteers were studied after 12 h of fasting before and during epinephrine infusion and after 84 h of fasting, before and during glucose infusion when plasma glucose was restored to postabsorptive values, and during glucose plus epinephrine infusion. In another protocol, five volunteers were given glucose intravenously throughout fasting to maintain plasma glucose at postabsorptive levels and isotopic studies were performed after 12 and 84 h of fasting before and during epinephrine infusion. Glucose infusion after 84 h of fasting restored glucose and insulin concentrations and lipolytic rates toward 12-h fasting values. When euglycemia was maintained throughout fasting, plasma insulin still declined (P less than 0.05) and lipolytic rates still increased (P less than 0.05). Despite similar glucose concentrations, the lipolytic response to epinephrine infusion was greater after 84 h than after 12 h of fasting in both protocols (P less than 0.05). These studies demonstrate that the decline in plasma glucose contributes to, but is not required for, the increase in lipolysis during fasting. The increase in epinephrine-stimulated lipolysis that occurs during fasting is not dependent on a decrease in plasma glucose concentration.

THE EFFECTS OF HORMONES ON THE CARBOHYDRATE METABOLISM OF THE LAMPREY LAMPETRA FLUVIATILIS

1965 ◽  
Vol 31 (2) ◽  
pp. 127-137 ◽  
Author(s):  
P. J. BENTLEY ◽  
B. K. FOLLETT
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Carbohydrate Metabolism ◽  
Glucose Concentration ◽  
Skeletal Muscles ◽  
Blood Glucose Concentration ◽  
Liver Glycogen ◽  
Arginine Vasotocin ◽  
Glycogen Concentration ◽  
Muscle Glycogen Concentration

SUMMARY River lampreys regulated their blood glucose concentration when injected with glucose. Mammalian insulin decreased the blood glucose concentration in the lamprey while adrenaline, cortisol and arginine vasotocin increased it. Glucagon had no effect initially but after a delay of 4 hr. decreased the blood glucose level. Insulin and cortisol increased the liver glycogen concentration. Adrenaline decreased the muscle glycogen concentration; vasotocin increased it. Treatment with alloxan increased the blood glucose concentration. Fat and glycogen in the lamprey are stored mainly in the skeletal muscles and their histochemical distribution in muscle is described. The results are discussed in relation to the metabolism of the migrating lamprey and the evolution of the control of carbohydrate metabolism in vertebrates.

scholarly journals Blood glucose level in rats with different behavioral activity in the dynamics of repeated stress exposures

2019 ◽  
Vol 27 (1) ◽  
pp. 10-19
Author(s):  
Anastasiya Yu. Abramova ◽  
Elena V. Koplik ◽  
Irina V. Alekseyeva ◽  
Sergey S. Pertsov
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Stress Factors ◽  
Behavioral Activity ◽  
Glucose Content ◽  
Control Measurement ◽  
Repeated Stress

Aim. To study the effect of repeated stress on blood glucose level in rats with various behavioral characteristics and with different resistance to the development of adverse consequences of negative emotiogenic exposures. Materials and Methods. The animals were initially subjected to open field test to calculate the index of activity. Daily 4-h immobilization of rats in individual plastic cages for 8 days was used as a model of stress. Blood glucose concentration was measured with a glucometer (control measurement and on the 1st, 3rd and 8th days of repeated stress). Results. The basal level of glucose in behaviorally active (stress-resistant) rats was lower than in passive (stress-predisposed) specimens. Repeated exposure of rats to stress resulted in development of hyperglycemia. However, the dynamics of blood glucose concentration was different in specimens with different parameters of behavior. The increase in glucose concentration in active animals was most pronounced after a single exposure. By the 3rd and 8th days of stress exposures, glucose level in these rats progressively decreased (as compared to the 1st day), but remained above the basal level. Passive specimens were characterized by the increase in blood glucose concentration after a single and, particularly, after three-time restraint stress. Glucose content in these animals slightly decreased by the 8th day (as compared to the previous periods), but was above the basal level. Conclusion. The dynamics of abnormalities in carbohydrate metabolism (in particular, changes in blood glucose level) during chronic emotiogenic exposures differed in specimens with different resistance to stress factors. These data illustrate the importance of an indivi-dual approach to studying the pathophysiological mechanisms of progression and development of stress-induced disorders.

scholarly journals The Consequences of Prior Initiation of Breast Feeding on Blood Glucose Levels in Neonates Born In a Tertiary Care Hospital

2020 ◽  
Vol 8 (2) ◽  
pp. 23-29
Author(s):  
Rizwan-U- Zama ◽  
Ayesha Siddiqa ◽  
A.N. Thobbi ◽  
Tehseen Sajid Mudhol ◽  
R Shruthi
Keyword(s):  
Blood Glucose ◽  
Birth Weight ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Blood Glucose Concentration ◽  
Mode Of Delivery ◽  
Postnatal Life ◽  
Care Hospital ◽  
Glucose Levels ◽  
Blood Glucose Levels

Background: Hypoglycemia is the most common event of failure of metabolic adjustments in the newborn. Changes in maternal and fetal monitoring techniques, administration of glucose-containing solutions during labor, delivery and early feeding in neonates significantly alter blood glucose concentrations during the first week of postnatal life. Subjects and Methods: A total of 90 healthy (60 born by FTND, 30 born by LSCS) term, AGA infants were longitudinally evaluated at birth, at one hour after feeds (post feed), and after 6 hours of life. Plasma glucose was estimated from Heel Prick capillary samples by glucometer method. The influence of mode of delivery, the interval between feeds, sex, birth weight, on blood glucose was analyzed. Results: The way of delivery did not affect the plasma glucose concentration in neonates. There was a substantial increase in blood glucose concentration after the first feed irrespective of their birth weight. It was found that female babies had a higher blood glucose concentration than male babies during our study period. All babies maintained normal blood glucose with the continuation of breastfeeding. Conclusion: Plasma glucose levels are satisfactorily maintained in healthy term infants without resort to pre-lacteal feeds and mode of delivery did not influence plasma glucose. There is no need to check blood glucose levels routinely in an asymptomatic, healthy, term, breastfed infants.

Gluconeogenesis and the Cori cycle in 12-, 20-, and 40-h-fasted humans

1998 ◽  
Vol 275 (3) ◽  
pp. E537-E542 ◽  
Author(s):  
Joseph Katz ◽  
John A. Tayek
Keyword(s):  
Blood Glucose ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Glucose Production ◽  
Plasma Glucose Concentration ◽  
Prolonged Fasting ◽  
Cori Cycle ◽  
Isotopomer Analysis ◽  
Mass Isotopomer

Six subjects were infused with [U-13C]glucose (0.03–0.05 mg ⋅ kg−1 ⋅ min−1) starting 8–9 h after a meal, and the production of glucose, the recycling of glucose (the Cori cycle), the dilution of glucose by unlabeled carbon into the hepatic lactate-pyruvate pool, and gluconeogenesis were determined in these fasted volunteers by use of mass isotopomer analysis and equations previously described [J. A. Tayek and J. Katz. Am. J. Physiol.272 ( Endocrinol. Metab. 35): E476–E484, 1997]. A primed continuous 11-h infusion was started at 6:00 AM, and the above parameters were calculated after 3 h (for the 12-h fast) and at the end of the infusion (for the 20-h fast). Another group of five subjects was fasted for 40 h, and the above parameters were calculated as before. At 12, 20, and 40 h of fasting, respectively, blood glucose was 93 ± 2, 83 ± 2, and 71 ± 2 (SE) mg/dl; glucose production was 2.3, 1.8, and 1.77 mg ⋅ kg−1 ⋅ min−1; the recycling of labeled carbon was 8, 15, and 15%, and that of glucose molecules (Cori cycle) was 18, 35, and 36%; the contribution of gluconeogenesis to glucose production was 41, 71, and 92% or 0.96, 1.29, and 1.64 mg ⋅ kg−1 ⋅ min−1; and the contribution of other sources to glucose production was 1.37, 0.53, and 0.15 mg ⋅ kg−1 ⋅ min−1. The recycling of glucose is important in prolonged fasting for the maintenance of plasma glucose concentration. We demonstrate here that gluconeogenesis can be easily measured and that it accounts for ∼90% of glucose production after a 40-h fast.

Insulin secretion: mechanism of the stimulation by glucose

1975 ◽  
Vol 8 (1) ◽  
pp. 1-41 ◽  
Author(s):  
Erol Cerasi
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Insulin Secretion ◽  
Blood Glucose ◽  
Food Intake ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Glucose Concentration ◽  
The Central Nervous System ◽  
The Stability

Glucose is one of the substrates that is controlled with the most efficient hormonal mechanisms in higher organisms. The presence of tissues such as the central nervous system which, under normal conditions, depend solely on glucose as substrate, and the sporadic type of food intake with periods of fasting of various lengths in the mammalians necessitate that the distribution of energy-rich substrates among various tissues be continuously adjusted by changes in the secretion of a number of hormones. The efficiency of this system is evidenced by the stability of the blood glucose level in man, in whom after a carbohydrate-rich meal more than 70% of the glucose that has been ingested will be retained in the liver during a single passage of portal blood, resulting in only small changes of the glucose concentration in peripheral blood. Likewise, periods of fasting up to24–36 h are followed by modest to minimal reductions of the blood glucose level, the liver now supplying the circulation with the hexose.

Influence of Carbohydrate Ingestion on Blood Glucose and Performance in Runners

1992 ◽  
Vol 2 (4) ◽  
pp. 317-327 ◽  
Author(s):  
Randall L. Wilber ◽  
Robert J. Moffatt
Keyword(s):  
Blood Glucose ◽  
Glucose Concentration ◽  
Perceived Exertion ◽  
Treadmill Exercise ◽  
Blood Glucose Concentration ◽  
Endurance Performance ◽  
Time To Exhaustion ◽  
Experimental Conditions ◽  
Double Blind ◽  
Carbohydrate Ingestion

Ten trained male runners performed a treadmill exercise test at 80%under two experimental conditions, carbohydrate (CHO, 7% carbohydrate) and placebo (P), to determine the effect of carbohydrate ingestion on endurance performance (treadmill run time), blood glucose concentration, respiratory exchange ratio (RER), and subjective ratings of perceived exertion (RPE). Treatment order was randomized and counterbalanced and test solutions were administered double-blind. Ingestion took place 5 min preexercise (250 ml) and at 15-min intervals during exercise (125 ml). Performance was enhanced by 29.4% (p~ 0.05) during CHO (115 ±25 min) compared to P (92 ± 27 min). Blood glucose concentration was significantly greater during CHO (5.6 ± 0.9 mM) relative to P (5.0 ±0.7 mM). There was a significant increase in mean RER following CHO ingestion (.94±.01) compared to P (.90±.01). Average RPE was significantly less during CHO (14.5±2.3) relative to P (15.4±2.4). These data suggest that time to exhaustion of high-intensity treadmill exercise is delayed as a result of carbohydrate ingestion and that this effect is mediated by favorable alterations in blood glucose concentration and substrate utilization.

scholarly journals Blood glucose concentration measured in EDTA/F plasma and serum in a referral clinical laboratory in Nepal

2021 ◽  
Vol 11 (1) ◽  
pp. 1837-1841
Author(s):  
Vivek Pant ◽  
Keyoor Gautam ◽  
Santosh Pradhan ◽  
Devish Pyakurel ◽  
Abha Shrestha
Keyword(s):  
Blood Glucose ◽  
Sodium Fluoride ◽  
Plasma Glucose ◽  
Glucose Concentration ◽  
Clinical Laboratory ◽  
Blood Glucose Concentration ◽  
Serum Glucose ◽  
Relative Reduction ◽  
The Difference ◽  
Glucose Estimation

Background: Sodium fluoride tubes or serum separator tubes are mostly used for blood glucose estimation in the clinical laboratories of Nepal. The study aimed to investigate the stability of glucose in samples collected in serum separator tubes and sodium fluoride/sodium ethylenediaminetetraacetic tubes by comparing the glucose concentration at 30 minutes and 4 hours collected and handled differently to simulate prolonged sample transport between venipunctures, centrifugation, and measurement.Materials and Methods: Samples were collected from healthy volunteers into two different serum separator tubes and two different sodium fluoride/sodium ethylenediaminetetraacetic tubes. Glucose concentration was measured at 30 minutes after venipuncture and compared with results from the same samples analyzed at four hours and with the results from tubes centrifuged with a delay of 4 hours. Differences between baseline and respective delayed analyzed glucose values for each tube type were tested using the Student’s paired t-test and Deming regression.Results: When comparing plasma glucose at 30 minutes, glycolysis caused a relative reduction of the glucose concentration in serum at 30 minutes of 3.1 %, which is only slightly less than at 4 hours (3.7 %). This is still substantially more than the reduction in plasma at 4 hours (1.3 %). Surprisingly, the difference between plasma glucose at 30 minutes and serum glucose at 4 hours was only 1.9% which is not clinically significant.Conclusions: The Na-F/Na2 EDTA tubes and serum separator tubes can be used interchangeably for analysis of blood glucose up to 4 hours if centrifuged within 30 minutes.

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