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Colegio de Medicina Interna de México.

2018, Number 6

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Med Int Mex 2018; 34 (6)

Hypoglycemia: Time is brain. What are we doing wrong?

Nares-Torices MÁ, González-Martínez A, Martínez-Ayuso FA, Morales-Fernández MO

Language: Spanish
References: 10
Page: 881-895
PDF size: 457.86 Kb.


ABSTRACT

Acute complications of diabetes account for approximately 20 to 30% of adult patients hospitalized in the emergency department. Approximately 90% of all patients receiving insulin experience at least one episode of hypoglycemia. As serum glucose levels decrease, a series of responses in the body occurs in a staggered fashion. The first triggered mechanism of defense is the cessation of insulin production in pancreatic B cells, appearing at approximately 80 mg/dL. Second, increased glucagon secretion appears around 68 mg/dL. Brain tissue consumes approximately 25% of total body consumption in its post-absorptive state. Serum glucose crosses the blood-brain barrier through the capillaries by diffusion facilitated by the GLUT-1 transporter. The most sensitive areas to decreased glycemic intake are the cortex, hippocampus and striatum. This article provides an overview of hypoglycemia pathophysiology, with emphasis on its deleterious effects on brain tissue, as well as its approach to physicians in the emergency department.


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