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| Authors | S Vella M J Cachia N Vella |
| Abstract | Hypoglycaemia is a well recognized and frequently encountered complication in insulin treated diabetic individuals. In adult type I diabetic patients, C-peptide negativity, a previous event of severe hypoglycaemia, patients determination to reach normoglycaemia and a lower social class have been identified as risk factors for severe hypoglycaemia. In type I diabetes, the glucagon response is impaired, thereby reducing the efficiency of the counter-regulatory response. This failure of the glucagon response occurs within about five years of the onset of the disease. Type I diabetics with longer disease duration may also have an impaired cathecolamine response, further predisposing to hypoglycaemia and reducing symptomatic awareness. The association of autoimmune Addisons disease with type I diabetes in patients with polyglandular autoimmune syndrome type II further compromises the physiological response to hypoglycaemia. We present a recent case of insulin induced fatal hypoglycaemic encephalopathy in one such Maltese patient. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 15 Issue 1-2/suppl. 2003 |
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| Key words | autoimmune syndrome, case report, mortality, hypocalcaemia |