Characteristics of severe hypoglycemia in the patient with insulin-dependent diabetes.

Abstract:

:To avoid, delay, or ameliorate the microvascular complications of diabetes, intensive insulin therapy with the goal of normoglycemia is required. In most patients with insulin-dependent diabetes mellitus (IDDM), this cannot be achieved because of severe hypoglycemia, which is one of the major causes of morbidity in diabetic patients. To assess the frequency and characteristics of severe hypoglycemia in a single diabetologist's practice, we surveyed 211 consecutive patients with IDDM for a history of severe hypoglycemia (SH), defined as events requiring the assistance of another person. Of these 211 patients, 135 (64%) had at some time had SH. Those with SH had a longer duration of IDDM, currently took more insulin injections, had a higher prevalence of neuropathy and nephropathy, and were less likely to be using human insulin. No difference was found in age, average glycosylated hemoglobin level, frequency of home glucose monitoring, or presence of retinopathy. Half of the patients with SH had confusion and were treated with glucose orally. The remainder were in coma and received i.v. glucose or IM glucagon. Perceived causes of SH were lack of food, excessive insulin, and unusual exercise. We conclude that the frequency of SH is underestimated in clinical practice. Risk factors for SH are longer duration of IDDM, presence of neuropathy and nephropathy, and use of animal insulin. Better education in avoidance and treatment of SH would reduce the morbidity of SH.

journal_name

South Med J

journal_title

Southern medical journal

authors

Bell DS,Cutter G

doi

10.1097/00007611-199406000-00007

subject

Has Abstract

pub_date

1994-06-01 00:00:00

pages

616-20

issue

6

eissn

0038-4348

issn

1541-8243

journal_volume

87

pub_type

杂志文章
  • Blastomycosis of bones and joints.

    abstract::A retrospective study of 45 patients hospitalized with blastomycosis of bones or joints revealed 41 cases of osteomyelitis and 12 cases of septic arthritis. The majority were men (35 [78%] patients) and non-Aboriginal (32 [71%] patients). Median time from the onset of symptoms to hospitalization was shorter in women t...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/SMJ.0b013e3180487a92

    authors: Oppenheimer M,Embil JM,Black B,Wiebe L,Limerick B,MacDonald K,Trepman E

    更新日期:2007-06-01 00:00:00

  • Combined paraesophageal and sliding hiatal hernia.

    abstract::We have reported a case of a large paraesophageal herniation with a small sliding component. Abnormal positioning of the esophagogastric junction or the necessity for mobilizing it during repair requires the addition of an antireflux procedure to the standard reduction and repair. Elective repair of a paraesophageal h...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198809000-00027

    authors: Chapman JE Jr,Kamath MV,Wilson BW

    更新日期:1988-09-01 00:00:00

  • A complication of an unusual sexual practice.

    abstract::A patient presented with scrotal cellulitis as a complication of infusing 900 ml saline into his scrotum. He had obtained a kit along with explicit instructions for performing the infusion through the Internet. This practice may be more widespread than expected. An Internet search revealed many references to this proc...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/01.SMJ.0000078368.00806.A7

    authors: Summers JA

    更新日期:2003-07-01 00:00:00

  • Cerebrospinal rhinorrhea: diagnosis and management.

    abstract::The role of the otolaryngologist in the diagnosis and management of cerebrospinal fluid rhinorrhea is discussed. One hundred eight cases of cerebrospinal rhinorrhea were studied with emphasis on cause, localization, and treatment. Extracranial approaches produce minimal morbidity and should be considered as possible t...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-197512000-00015

    authors: Hudson WR,Hughes LA

    更新日期:1975-12-01 00:00:00

  • Evaluation of state-provided postexposure prophylaxis against rabies in Florida.

    abstract:BACKGROUND:One key component of human rabies prevention is the use of postexposure prophylaxis (PEP). No information is routinely available to evaluate the appropriateness of this intervention. METHODS:A survey queried county health departments regarding rabies PEP administered during July through September in 1997 an...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Conti L,Wiersma S,Hopkins R

    更新日期:2002-02-01 00:00:00

  • Chronic myelocytic leukemia with near-total pulmonary microvascular obstruction by platelets.

    abstract::We have described a patient with long-standing chronic granulocytic leukemia. Although most patients with this disorder eventually have a picture of acute leukemia (blast crisis), this patient had massive thrombocytosis (platelet count greater than 5.000 x 10(9)/L) without major symptoms, but he died after transfusion...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198804000-00029

    authors: Blachly RJ,Herring GF,Mansouri A

    更新日期:1988-04-01 00:00:00

  • Staphylococcus epidermidis endocarditis: a community-acquired methicillin-resistant isolate.

    abstract::We have described a patient with community-acquired, methicillin-resistant Staphylococcus epidermidis endocarditis that occurred on a prolapsing mitral valve. The patient was successfully treated with vancomycin and rifampin for six weeks and had no signs of relapse four months later. ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Lockman DS,Chew WH,Rissing JP

    更新日期:1983-09-01 00:00:00

  • Home dialysis program of the Nashville VA Hospital.

    abstract::Since 1965, 330 patients have received chronic dialysis treatment at the Nashville VA Hospital. Home hemodialysis training was established in 1968, and a unique class format has been used since 1970. Despite the national trend of fewer patients beginning home dialysis each year, more than 50 percent of our patients ha...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-197712000-00016

    authors: Latos DL,Spannuth CL,Stone WJ

    更新日期:1977-12-01 00:00:00

  • Emergency department orthopedics observation unit as an alternative to admission.

    abstract:OBJECTIVES:Inclusion of select orthopedic problems in the orthopedics observation unit (OOU) may reduce hospital admissions. Our system allows OOU status for 24 hours, but the effect on admissions is unknown. Our primary hypothesis was that we could predict which OOU patients required admission based on the presence of...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.14423/SMJ.0000000000000181

    authors: Ernst AA,Jones J,Weiss SJ,Silva O

    更新日期:2014-10-01 00:00:00

  • Prostatic carcinoma: a trilogy of clinical expressions.

    abstract::A review of the available clinical and pathologic information suggests that the biologic behavior of prostatic carcinoma can be characterized by one of three different tumor-growth kinetic curves. Failure to identify the biologic potential of the tumor, as indicated by the pattern of its growth curve, can result in in...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Johnson DE,von Eschenbach AC

    更新日期:1980-10-01 00:00:00

  • Risk factors for gallstone disease in a hospital-based study.

    abstract:BACKGROUND:We investigated the risk factors for gallstone disease in Taiwan. METHODS:We retrospectively analyzed medical records of patients receiving periodic health examination at China Medical College Hospital from January to December 2000. A detailed history, physical examination, biochemical measurements, and abd...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Lai SW,Ng KC

    更新日期:2002-12-01 00:00:00

  • LOGIQ E9 Shear Wave Elastrography for Detection of Liver Fibrosis in Patients with Chronic Hepatitis C Virus.

    abstract:OBJECTIVES:Shear wave elastography (SWE) is an emerging technology that assesses hepatic fibrosis. The aim of our study was to determine the diagnostic accuracy of General Electric (GE) Healthcare's LOGIQ E9 SWE in patients with chronic hepatitis C virus using liver biopsy as the reference standard. METHODS:The liver ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.14423/SMJ.0000000000000562

    authors: Abrams GA,Jamal H,Deeter WT 3rd,Patil N

    更新日期:2016-11-01 00:00:00

  • Oligohydramnios sequence (Potter's syndrome): case clustering in northeastern Tennessee.

    abstract::The oligohydramnios sequence (OS) is manifest in newborns when prolonged oligohydramnios has been present during pregnancy. The most important signs are an infant small for gestational age, with wrinkled skin, Potter facies, compression deformities of the limbs, and respiratory distress caused by pulmonary hypoplasia....

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Prouty LA,Myers TL

    更新日期:1987-05-01 00:00:00

  • Central pontine myelinolysis as a manifestation of the paraneoplastic syndrome.

    abstract::We have described a patient who had lung carcinoma, syndrome of inappropriate antidiuretic hormone, and central pontine myelinolysis (CPM). Although this association is well-known, it appears to be the first report having radiographic documentation of both the intracranial and intrathoracic abnormalities. When searchi...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199204000-00019

    authors: Hardjasudarma M,Husain F,Fowler M,Eisenberg RL,Mirfakhraee M

    更新日期:1992-04-01 00:00:00

  • Comorbidity of schizophreniform disorder and borderline personality disorder in an 18-year-old black woman.

    abstract::We describe a rare occurrence of comorbidity of schizophreniform disorder and borderline personality disorder as an initial patient presentation. ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199803000-00013

    authors: Houry D,Johnson J,Cabrejos C

    更新日期:1998-03-01 00:00:00

  • Massive bleeding in a Zenker's diverticulum.

    abstract::Massive bleeding from a pharyngoesophageal diverticulum is a rarely reported condition, with only two reported cases in the literature. This report describes a patient who had massive bleeding due to ulceration in the base of a pharyngoesophageal diverticulum, presumed to have been caused by chronic aspirin ingestion....

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199003000-00033

    authors: Hendren WG,Anderson T,Miller JI

    更新日期:1990-03-01 00:00:00

  • Proportion and Characterization of Co-infections of HIV and Hepatitis C or Hepatitis B among People with HIV in Alabama, 2007-2016.

    abstract:OBJECTIVES:People living with human immunodeficiency virus (HIV) have an increased risk of other infections, including viral hepatitis, which can complicate the treatment and progression of the disease. We sought to characterize Alabama cases of HIV co-infected with hepatitis C virus or hepatitis B virus. METHODS:Usin...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.14423/SMJ.0000000000001104

    authors: Siza C,Bixler D,Davidson S

    更新日期:2020-06-01 00:00:00

  • Rhinitis medicamentosa: the forgotten factor in nasal obstruction.

    abstract::Rebound nasal mucosal edema may follow the use of topical nasal vasoconstrictors for even a short time. The physician seeing a patient with nasal stuffiness should always ask about the usage of these substances. Management of patients with rhinitis medicamentosa includes making the diagnosis, reversing the mucosal cha...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:

    authors: Mabry RL

    更新日期:1982-07-01 00:00:00

  • Drug-induced hypertriglyceridemia with and without pancreatitis.

    abstract::We describe two cases of drug-induced hypertriglyceridemia, one associated with interferon alfa-2b and the other with asparaginase, each of which is mediated through a different mechanism. Hypertriglyceridemia caused by these medications is not listed as an adverse reaction in the Physicians' Desk Reference, one of th...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审

    doi:10.1097/00007611-199909000-00013

    authors: Keung YK,Rizk R,Wu XY,Cobos E

    更新日期:1999-09-01 00:00:00

  • Adult respiratory distress syndrome.

    abstract::Treatment of the adult respiratory distress syndrome requires an understanding of the current concepts of the pathogenesis of this syndrome. The clinical features and pathophysiology are briefly discussed. Differential diagnosis requires the exclusion of pulmonary infection and left heart failure. Therapy is aimed at ...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审

    doi:10.1097/00007611-197811000-00028

    authors: Burki NK

    更新日期:1978-11-01 00:00:00

  • Laryngeal microsurgery without intubation.

    abstract::Reviewed are 200 cases in which endolaryngeal suspension microsurgical procedures were done using intravenous anesthesia and Venturi insufflation oxygenation. Patients included 177 adults and 23 children, ranging in age from 20 months to 88 years. No significant complications were observed. The technic allowed the glo...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-197607000-00003

    authors: Urban GE Jr

    更新日期:1976-07-01 00:00:00

  • Pancreatic pseudocyst with splenic involvement: an uncommon complication of pancreatitis.

    abstract::We have presented a case of chronic pancreatitis with pseudocyst involvement of the spleen complicated by splenic rupture. This complication is uncommon, only 19 cases having been reported. As illustrated by our case, there is a high risk of hemorrhage from a pseudocyst involving the spleen and pancreas. Immediate sur...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198807000-00025

    authors: McMahon NG,Norwood SH,Silva JS

    更新日期:1988-07-01 00:00:00

  • Advice on stroke provided by pharmacies in the United States: implications for treatment and care.

    abstract:OBJECTIVES:Studies have found that some health lines and physician's offices have provided treatment advice other than "call 9-1-1 for an ambulance" to patients who present with a stroke scenario. We assessed the treatment advice given by selected pharmacies in the United States regarding stroke. METHODS:The investiga...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.14423/SMJ.0000000000000262

    authors: Monseau AJ,Whiteman C,Crocco TJ,Davis SM,Barkley J

    更新日期:2015-04-01 00:00:00

  • Videoscopically assisted fascia lata harvest for the correction of recurrent ventral hernia.

    abstract::Autologous fascia lata tissue transfer is a feasible alternative to reconstruction of the abdominal wall in selected patients. We describe a new technique using minimally invasive technology that allows harvest of the fascia lata graft without the traditional large thigh incision. ...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199704000-00007

    authors: Tucker JG,Choat D,Zubowicz VN

    更新日期:1997-04-01 00:00:00

  • Neuroimaging of arachnoiditis induced by spinal anesthesia.

    abstract::Despite the simplicity, effectiveness, and safety of spinal anesthesia, arachnoiditis can occur as a complication. The cause of this is often unknown, especially since disposable spinal kits are now normally used. It is postulated that an untoward reaction to the anesthesia or chemical contamination was the cause of a...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199311000-00026

    authors: Hardjasudarma M,Davis DR 2nd

    更新日期:1993-11-01 00:00:00

  • Doctoring: the philosophic milieu.

    abstract::To understand fully a physician's role in society, and to deal successfully with the current sense of crisis, the medical profession must evolve a world-view that appropriately relates a physician to the patient, to the practice environment, to the base of knowledge, and to the physician's own sense of self. Such a wo...

    journal_title:Southern medical journal

    pub_type: 杂志文章,评审

    doi:10.1097/00007611-198812000-00022

    authors: Bessinger CD Jr

    更新日期:1988-12-01 00:00:00

  • Sucralfate in the relief of gastrointestinal symptoms associated with nonsteroidal anti-inflammatory drugs.

    abstract::Sucralfate is an unabsorbed antiulcer drug that binds to gastrointestinal tissue and protects it from acid and pepsin. Twenty-two arthritic patients taking nonsteroidal anti-inflammatory drugs (NSAIDs) were given sucralfate concomitantly for two weeks in an attempt to lessen gastrointestinal side effects. Changes from...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-198508000-00011

    authors: Caldwell JR

    更新日期:1985-08-01 00:00:00

  • Does patient age or intestinal pathology influence the bacteria found in cases of necrotizing enterocolitis?

    abstract::To evaluate the relationship between bacterial colonization in neonatal peritonitis and patient age or intestinal pathology, we retrospectively reviewed peritoneal culture results from 96 infants having surgery for necrotizing enterocolitis. Microorganisms recovered mirrored those usually found as fecal flora within t...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199107000-00014

    authors: Mollitt DL,String DL,Tepas JJ 3rd,Talbert JL

    更新日期:1991-07-01 00:00:00

  • Acute pancreatitis associated with ketoprofen.

    abstract::An 80-year-old man had acute pancreatitis during the fourth week of antibiotic therapy for enterococcal endocarditis and 12 days after initiation of ketoprofen therapy for osteoarthritis of the hip. Pancreatitis resolved after discontinuance of ketoprofen therapy and while continuing antibiotic therapy for endocarditi...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-199204000-00023

    authors: Cobb TK,Pierce JR Jr

    更新日期:1992-04-01 00:00:00

  • Agenesis of the gallbladder--an inherited defect?

    abstract::Agenesis of the gallbladder is a rare anomaly believed to be an organogenetic failure. This is the third instance of familial agenesis of the gallbladder reported in the literature. The diagnosis of agenesis of the gallbladder can only be made during exploratory celiotomy and must be confirmed by an intraoperative nee...

    journal_title:Southern medical journal

    pub_type: 杂志文章

    doi:10.1097/00007611-197704000-00041

    authors: Sterchi JM,Baine RW,Myers RT

    更新日期:1977-04-01 00:00:00