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Academia Mexicana de Neurología, A.C.

2012, Number 2

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Rev Mex Neuroci 2012; 13 (2)

Hypoglycemia and brain death

Alatorre-Fernández CP, Castro-Martínez E, Hernández-Erazo ID, Balderas-Juárez J, Estévez-Sánchez P

Language: Spanish
References: 21
Page: 104-108
PDF size: 587.95 Kb.


ABSTRACT

Introduction: Hypoglycemia is a frequent event in patients with diabetes mellitus (DM). When the reduction is severe and prolonged blood glucose can cause brain damage manifested by memory and/or cognitive impairment, dementia and brain death. The mechanisms involved in hypoglycemic neuronal death are varied and have as a common element the oxidative stress, which suggest that the greatest neuronal damage does not occur during the period of hypoglycemia, but possibly during glucose replacement. Case report: We report the case of a diabetic patient with hypoglycemia associated with prolonged diarrhea syndrome and hyporexia, who progressed to coma and death. Conclusions: The main limiting factor in the management of type 1 and 2 DM is hypoglycemia. Brain death secondary to severe reduction in blood glucose levels is rare, but it must be considered in patients with risk factors for prolonged hypoglycemia, due to the association with altered nutritional status, heart failure, kidney or liver disease, neoplasia, infection or sepsis. Knowledge of the mechanisms leading to neuronal death during glucose replacement, force us to be cautious after an episode of hypoglycemia, which avoid severe complications and even death.


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