Hypoglycemia-Associated Autonomic Failure in Type 1 Diabetes: Beyond Hypoglycemia Unawareness

A 14-year-old girl with a 4-year history of type 1 diabetes was admitted to our hospital after a severe hypoglycemic episode. After a usual morning awakening and before the mealtime insulin injection for breakfast, while sitting in bed and reading a magazine, she suddenly lost consciousness and star...

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Bibliographic Details
Published in:Clinical diabetes 2022-04, Vol.40 (2), p.250-252
Main Authors: Giannakopoulos, Aristeidis, Efthymiadou, Alexandra, Chrysanthakopoulou, Anastasia, Chrysis, Dionisios
Format: Article
Language:English
Subjects:
Case Studies
Diabetes
Disease management
Family medical history
Glucose
Hypoglycemia
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Summary:A 14-year-old girl with a 4-year history of type 1 diabetes was admitted to our hospital after a severe hypoglycemic episode. After a usual morning awakening and before the mealtime insulin injection for breakfast, while sitting in bed and reading a magazine, she suddenly lost consciousness and started having generalized seizures, progressing into coma. The blood glucose reading on her glucose meter showed "low," and her mother immediately administrated 1 mg of glucagon intramuscularly, after which she recovered. At admission, her orthostatic vital signs were normal (heart rate 84 bpm and blood pressure 111/66 mmHg when supine and heart rate 85 bpm and blood pressure 110/68 mmHg in a standing position), and her oxygen saturation was 98%. Her neurologic examination was normal, with no fever or other clinical signs of infection. She did not recall having any adrenergic symptoms such as tremor, sweating, or headache before losing consciousness.
ISSN:0891-8929
1945-4953
DOI:10.2337/CD21-0100