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Reading impairment after neonatal Hypoglycemia with parietotemporo-occipital injury without cortical blindness:A case report

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World Journal of Clinical Cases 2023年第16期11卷 3899-3906页

作者： Naoko Kurahashi Shunsuke Ogaya Yuki Maki Norie Nonobe Sumire Kumai Yosuke Hosokawa Chikako Ogawa Keitaro Yamada Koichi Maruyama Kiyokuni Miura Miho Nakamura Department of Pediatric Neurology Central HospitalAichi Developmental Disability CenterKasugai 480-0392AichiJapan Department of Pediatrics Nagoya University Graduate School of MedicineNagoya 466-8560AichiJapan Division of Neonatology Center for Maternal-Neonatal Care Nagoya University HospitalNagoya 466-8560AichiJapan Department of Pediatrics Tokyo Metropolitan Fuchu Medical Center for the DisabledFuchu 183-0042TokyoJapan Department of Functioning and Disability Institute for Developmental ResearchAichi Developmental Disability CenterKasugai 480-0392AichiJapan Okazaki Medical Center for Child Development Okazaki 444-0011AichiJapan

BACKGROUND Perinatal brain injury may lead to later neurodevelopmental disorders,whose outcomes may vary due to neuroplasticity in young children.Recent neuroimaging studies have shown that the left parietotemporal area(which includes the left inferior parietal lobe)is associated with phonological awareness and decoding skills,which are essential skills for reading acquisition in children.However,the literature on the effect of perinatal cerebral injury on the development of phonological awareness or decoding ability in childhood is limited.CASE SUMMARY We report the case of an 8-year-old boy who presented with reading difficulty following a perinatal injury in the parieto-temporal-occipital lobes.The patient was born at term and was treated for Hypoglycemia and seizures during the neonatal period.Diffusion-weighted brain magnetic resonance imaging on postnatal day 4 revealed cortical and subcortical hyperintensities in the parieto-temporo-occipital lobe.At the age of 8 years,physical examination was unremarkable,aside from mild clumsiness.Despite occipital lobe injury,the patient had adequate visual acuity,normal eye movement,and no visual field defects.Full-scale intelligence quotient and verbal comprehension index on Wechsler Intelligence Scale for Children-Fourth Edition were 75 and 90,respectively.Further assessment revealed adequate recognition of Japanese Hiragana letters.However,he had significantly slower reading speed in the Hiragana reading test than control children.The phonological awareness test revealed significant errors(standard deviation+2.7)in the mora reversal task.CONCLUSION Patients with perinatal brain injuries in the parietotemporal area require attention and may benefit from additional reading instructions.

关键词： Brain diseases Hypoglycemia Dyslexia Long-term care Education Case report

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Comparison of gliclazide vs linagliptin on Hypoglycemia and cardiovascular events in type 2 diabetes mellitus: A systematic review

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World Journal of Diabetes 2022年第12期13卷 1168-1183页

作者： Viswanathan Mohan Subhash Wangnoo Sambit Das Rajnish Dhediya Kumar Gaurav Department of Diabetes Madras Diabetes Research Foundation&Dr Mohan’s Diabetes Specialties CentreChennai 600086Tamil NaduIndia Department of Diabetes Apollo Hospital Education and Research FoundationNew Delhi 110001India Department of Endocrinology Endeavour ClinicsBhubaneswar 750017India Medical Affairs Dr.Reddy’s Laboratories LtdHyderabad 500016India

BACKGROUND Cardiovascular outcome trials have demonstrated cardiovascular safety of glimepiride(a sulfonylureas) against dipeptidyl peptidase-4 inhibitor linagliptin.Gliclazide(another newer sulfonylureas) has shown similar glycemic efficacy and 50% decreased risk of Hypoglycemia compared to glimepiride.AIM Considering the absence of cardiovascular outcome trials for gliclazide, we decided to conduct a systematic review of the literature to assess the cardiovascular(CV) safety by assessing the risk for major adverse CV events and Hypoglycemia risk of gliclazide vs linagliptin in patients with type 2 diabetes(T2D).METHODS This systematic review followed the current Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to analyze all the clinical studies published from 2008 that compared the two drugs in patients with T2D with no risk of CV disease(CVD). We included only evidence designated high quality by the Oxford Center for Evidence-based Medicine-Levels of Evidence.RESULTS Eight clinical studies were included in the narrative descriptive analysis(gliclazide: 5 and linagliptin: 3). The CV safety of gliclazide in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation trial and of linagliptin in the Cardiovascular and Renal Microvascular Outcome Study With Linagliptin(CARMELINA) and CARdiovascular Outcome study of LINAgliptin vs glimepiride in patients with T2D(CAROLINA)trials were excluded from the comparative analysis as these trials demonstrated CV and Hypoglycemia benefits in patients at high risk of CVD. However, since these are landmark trials,they were discussed in brief to show the CV benefits and low Hypoglycemia risk of gliclazide and linagliptin. We did not find any study comparing gliclazide with linagliptin. Hence, direct comparison of their major adverse CV events and Hypoglycemia risk could not be carried out.However, the literature meeting the inclusion criteria showed that both drugs were effective in achieving the desire

关键词： Linagliptin Gliclazide Hypoglycemia Major cardiovascular adverse events Type 2 diabetes

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Potential contribution of the gut microbiota to Hypoglycemia after gastric bypass surgery

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Chinese Medical Journal 2020年第15期133卷 1834-1843页

作者： Li-Yuan Zhou Ming-Qun Deng Xin-Hua Xiao Key Laboratory of Endocrinology Translational Medicine CenterMinistry of HealthDepartment of EndocrinologyPeking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China

Obesity has become a global health problem. Lifestyle modification and medical treatment only appear to yield short-term weight loss. Roux-en-Y gastric bypass (RYGB) is the most popular bariatric procedure, and it sustains weight reduction and results in the remission of obesity-associated comorbidities for obese individuals. However, patients who undergo this surgery may develop Hypoglycemia. To date, the diagnosis is challenging and the prevalence of post-RYGB Hypoglycemia (PRH) is unclear. RYGB alters the anatomy of the upper gastrointestinal tract and has a combined effect of caloric intake restriction and nutrient malabsorption. Nevertheless, the physiologic changes after RYGB are complex. Although hyperinsulinemia, incretin effects, dysfunction of β-cells and α-cells, and some other factors have been widely investigated and are reported to be possible mediators of PRH, the pathogenesis is still not completely understood. In light of the important role of the gut microbiome in metabolism, we hypothesized that the gut microbiome might also be a critical link between RYGB and Hypoglycemia. In this review, we mainly highlight the current possible factors predisposing individuals to PRH, particularly related to the gut microbiota, which may yield significant insights into the intestinal regulation of glucose metabolic homeostasis and provide novel clues to improve the treatment of type 2 diabetes mellitus.

关键词： Roux-en-Y gastric bypass surgery Hypoglycemia Gut microbiota Obesity

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Reliability and validity of the Chinese version of the new fear of Hypoglycemia scale: FH-15

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International Journal of Nursing Sciences 2018年第4期5卷 343-351页

作者： Ya-Qian Liu Si-Qi Xiong Ming Sang Yu-Feng Li María Teresa Anarte Ortiz Qiu-Ling Xing Hong-Mei Xu Chang-De Jin Department of Graduate Tianjin University of Traditional Chinese MedicineTianjinChina University of Malaga Spain The Ministry of Health Key Laboratory of Hormone and Development Metabolic Disease Hospital of Tianjin Medical UniversityChina Department of Nursing Tianjin University of Traditional Chinese MedicineTianjinChina

Objective:This study aimed to evaluate the reliability and validity of the Chinese version of the Fear of Hypoglycemia scale with 15 items(FH-15).Methods:After obtaining the original author's authorization,the English version of the FH-15 scale was translated,back translated,and culturally debugged to obtain the Chinese version of FH-15.A convenient sampling method was used to extract patients with type 2 diabetes from four tertiary hospitals in Tianjin.A total of 408 patients with type 2 diabetes were investigated in the hospital to test the reliability and validity of Chinese version FH-15 scale.Results:The content validity index of the scale was 0.92,and the content validity index of each item was 0.8-1.0.The exploratory factor analysis extracted three common factors(fear,avoidance,and interference),which contained 15 items,and the cumulative variance contribution rate was 71.245%.The confirmatory factor analysis results showed that the model fit was better at 1.981 x2/df,GFI=0.901,CGI=0.962,TLI=0.952,and RMSEA=0.070.The cut-off value for the total Hypoglycemia fear scale was 30.5.The Cronbach'sαcoefficient of the three dimensions of the scale was 0.918,the Cronbach'sαcoefficient of each dimension is 0.876-0.916,the test-retest reliability was 0.903,and the test-retest reliability of each factor was 0.733-0.930.Conclusion:The Chinese version of the FH-15 scale can be considered reliable and valid.The item expression is concise,clear,and easy to understand.It is suitable for clinical practice as an initial screening tool to identify and evaluate the severity of fear of Hypoglycemia in patients with type 2 diabetes.

关键词： Diabetes mellitus Type 2 Fear Hypoglycemia Reliability Validity

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The role of central nervous system on Hypoglycemia and the feasibility of the brain theory in traditional Chinese medicine on treatment of diabetes mellitus

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Journal of Integrative Medicine 2014年第1期12卷 1-6页

作者： Hai-li Jiang Jing-jing Niu Wei-fei Zhang Wen-jin Huang Ming-yue Zhou Wen-jun Sha Jun-yan Li Fu-feng Li Ting Zhu Xin Xia Jun Zhang Yuan-dong Shen Li-gang Zhou Department of Endocrinology Shanghai Pudong HospitalFudan University Pudong Medical Center Department of Endocrinology Shuguang HospitalShanghai University of Traditional Chinese Medicine Diabetes Research Center Shanghai University of Traditional Chinese Medicine Basic Medical Department Shanghai University of Traditional Chinese Medicine Biology and Biological Science Program University of California Department of Gerontology Shuguang HospitalShanghai University of Traditional Chinese Medicine Department of Endocrinology Shanghai East Hospital Department of Police Training Shanghai Police College

The central nervous system （CNS） plays a key regulatory role in glucose homeostasis. In particular, the brain is important in initiating and coordinating protective counterregulatory responses when blood glucose levels fall. This may due to the metabolic dependency of the CNS on glucose, and protection of food supply to the brain. In healthy subjects, blood glucose is normally maintained within a relatively narrow range. Hypoglycemia in diabetic patients can increase the risk of complications, such as heart disease and diabetic peripheral neuropathy. The clinical research finds that the use of traditional Chinese medicine （TCM） has a positive effect on the treatment of Hypoglycemia. Here the authors reviewed the current understanding of sensing and counterregulatory responses to Hypoglycemia, and discuss combining traditional Chinese and Western medicine and the theory of iatrogenic Hypoglycemia in diabetes treatment. Furthermore, the authors clarify the feasibility of treating Hypoglycemia on the basis of TCM theory and CNS and have an insight on its clinical practice.

关键词： diabetes mellitus Hypoglycemia counterrugulation hormone response neuroendocrine systems hypothalamus brain review

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Pancreatic somatostatinoma characterized by extreme Hypoglycemia

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Chinese Medical Journal 2009年第14期122卷 1709-1712页

作者： CAO Xiao-pei LIU Yuan-yuan XIAO Hai-peng LI Yan-bing WANG Lian-tang XIAO Ping Department of Endocrinology Department of Pathology First Affiliated Hospital Sun Yat-sen University Guangzhou Guangdong 510080 China

Somatostatinomas are very rare endocrine tumors, accounting for less than 1% of all gastrointestinal endocrine tumors. It usually arises within the pancreas and some from extrapancreafic sites, including the duodenum, ampulla, jejunum, or cystic duct,with an annual incidence of 1 in 40 million. Since the first case of pancreatic somatostafinoma was reported in 1977 by Larsson et al,4 less than 200 cases of somatostatinoma have been reported in literature, and only a few cases have been reported in China. The most described features of patients with somatostatinoma induced by excessive somatostatin secretion are characterized by cholelithiasis, steatorrbea, achlorhydria, hypochlorhydria and mild hyperglycemia, As somatostafin inhibits the secretion of insulin from pancreatic islets,

关键词： somatostatinoma Hypoglycemia somatostatin pancreatic tumor insulinoma

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Time and department distribution of Hypoglycemia occurrences in hospitalized diabetic patients

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International Journal of Nursing Sciences 2015年第3期2卷 263-267页

作者： Cun-mei Yang Yan-lan Ma Jun Kang Zhe Jia Yan-yan Wang Hong-ying Ma Jie Wang The Second Division of Cadre Ward The First Affiliated Hospital of the Chinese People's Liberation Army General HospitalBeijingChina Nursing Department The First Affiliated Hospital of the Chinese People's Liberation Army General HospitalBeijingChina Department of Endocrine and Rheumatism The First Affiliated Hospital of the Chinese People's Liberation Army General HospitalBeijingChina

Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Totally 105728 cases of blood glucose were monitored and 1374 cases of Hypoglycemia were detected.The incidence of Hypoglycemia was 1.29%.Among which,317 cases of severe Hypoglycemia were detected and the incidence of severe Hypoglycemia was 0.29%.The peak periods of Hypoglycemia were 0:00~2:00,22:00~24:00,2:00~4:00,8:00~10:00 and 10:00~12:00.The symptomatic Hypoglycemia accounted for 47.01%,The asymptomatic Hypoglycemia accounted for 52.98%.The incidence of Hypoglycemia was 1.49%in medical departments and 0.87%in surgical departments.It is suggested to be vigilant of high risk periods of Hypoglycemia,detect and treat asymptomatic Hypoglycemia timely and rationally administer antidiabetics to prevent Hypoglycemia.

关键词： Diabetes mellitus Hypoglycemia Hospitalized patients

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Fear of Hypoglycemia,a game changer during physical activity in type 1 diabetes mellitus patients

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World Journal of Diabetes 2021年第5期12卷 569-577页

作者： Maja Cigrovski Berkovic Ines Bilic-Curcic Lavinia La Grasta Sabolic Anna Mrzljak Vjekoslav Cigrovski Department of Endocrinology DiabetesMetabolism and Clinical PharmacologyUniversity Hospital DubravaZagreb 10000Croatia Department of Pharmacology Faculty of MedicineUniversity of J.J.Strossmayer OsijekOsijek 31000Croatia Department of Pediatric Endocrinology Diabetes and MetabolismUniversity Hospital Centre Sestre MilosrdniceZagreb 10000Croatia Department of Medicine Merkur University HospitalZagreb 10000Croatia School of Medicine University of ZagrebZagreb 10000Croatia Faculty of Kinesiology University of ZagrebZagreb 10000Croatia

Hypoglycemia limits optimal glycemic management of patients with type 1 diabetes mellitus(T1DM).Fear of Hypoglycemia(FoH)is a significant psychosocial consequence that negatively impacts the willingness of T1DM patients to engage in and profit from the health benefits of regular physical activity(e.g.,cardiometabolic health,improved body composition,cardiovascular fitness,quality of life).Technological advances,improved insulin regimens,and a better understanding of the physiology of various types of exercise could help ameliorate FoH.This narrative review summarizes the available literature on FoH in children and adults and tools to avoid it.

关键词： Hypoglycemia Fear of Hypoglycemia Type 1 diabetes mellitus Physical activity Modern technology Exercise management

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Late-onset non-islet cell tumor Hypoglycemia: A case report

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World Journal of Clinical Cases 2021年第1期9卷 163-169页

作者： Shunichi Matsumoto Eijiro Yamada Yasuyo Nakajima Naoki Yamaguchi Takashi Okamura Toshiki Yajima Satoshi Yoshino Kazuhiko Horiguchi Emi Ishida Masashi Yoshikawa Jun Nagaoka Sho Sekiguchi Mai Sue Shuichi Okada Izumi Fukuda Ken Shirabe Masanobu Yamada Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashi 371-8511GunmaJapan Division of General Thoracic Surgery Integrative Center of General SurgeryGunma University HospitalMaebashi 371-8511GunmaJapan Department of Endocrinology Diabetes and MetabolismGraduate School of Medicine Nippon Medical SchoolTokyo 1138602Japan

BACKGROUND Hypoglycemia due to non-insulin-producing tumors is referred to as non-islet cell tumor Hypoglycemia(NICTH).As NICTH is a rare lesion,the natural course of NICTH is not well understood.We report a case of NICTH that was observed 30 years before the onset of Hypoglycemia.CASE SUMMARY A 50-year-old man was diagnosed with an abnormal right chest shadow during a routine X-ray examination,but no further examination was undertaken because the lesion appeared benign.Thirty years after the tumor discovery,the patient was admitted to the hospital with symptoms of severe Hypoglycemia,which was diagnosed as NICTH based on a complete examination.The tumor was resected and found to be a solitary fibrous mass(15.6 cm×13.7 cm×10.4 cm);thereafter,the patient’s blood glucose levels normalized and he completely recovered.CONCLUSION NICTH can have an acute onset,even if the tumor has been present and asymptomatic over a long time period.

关键词： Hypoglycemia Non-islet cell tumor Hypoglycemia Blood glucose Solitary tumor Late onset Case report Insulin-like growth factor II

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Insulinoma presenting with postprandial Hypoglycemia and a low body mass index:A case report

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World Journal of Clinical Cases 2020年第18期8卷 4169-4176页

作者： Dana Prídavková Matej Samoš Roman Kyčina Katarína Adamicová Michal Kalman Margita Belicová Marián Mokáň Clinic of Internal Medicine Ⅰ Comenius University in BratislavaJessenius Faculty of Medicine in MartinMartin 03601Slovakia Clinic of Surgery and Transplant Center Comenius University in BratislavaJessenius Faculty of Medicine in MartinMartin 03601Slovakia Department of Pathological Anatomy Comenius University in BratislavaJessenius Faculty of Medicine in MartinMartin 03601Slovakia

BACKGROUND Insulinomas are the most common type of functioning endocrine neoplasms of the pancreas presenting hypoglycemic symptoms.Patients characteristically develop symptoms while fasting,but some patients have reported symptoms only in the postprandial state.Repeated and prolonged hypoglycemic episodes can reduce the awareness of adrenergic symptoms,and patients may have amnesia,which delays diagnosis.CASE SUMMARY We describe a case of a 24-year-old underweight patient who showed hypoglycemic symptoms for almost 6 years.Although patients with insulinoma characteristically develop symptoms while fasting,this young man had hypoglycemic symptoms up to one hour postprandially,especially after highsugar meals and after physical activity.The fasting tests and imaging methods performed at local hospitals were evaluated as negative for abnormal results.However,brown adipose tissue exhibited increased metabolic activity,and some muscle groups had histological changes as indicated by positron emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose integrated with computed tomography.Glycogen deficiency was also histologically confirmed.The patient’s symptoms progressed over the years and occurred more frequently,i.e.,several times a month,and the patient had reduced awareness of adrenergic symptoms.The follow-up fasting test was positive,and the imaging results showed a tumor in the head of the pancreas.The patient underwent laparotomy with enucleation of the insulinoma.CONCLUSION Weight gain and fasting Hypoglycemia are not necessarily characteristics of insulinoma.In prolonged cases,adrenergic symptoms can be suppressed.

关键词： Brown adipose tissue Glycogen deficit Hypoglycemia Insulinoma Underweight Case report

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