PMID: 3769716Sep 1, 1986Paper

Quantitative analysis of glucose loss during acute therapy for hyperglycemic hyperosmolar syndrome

Diabetes Care
M L WestM L Halperin

Abstract

Four patients with severe hyperglycemia and hyperosmolality were studied to quantitate the major mechanisms responsible for the fall in blood glucose concentration. Insulin was not administered to any of these patients during the first 15 h of therapy. In each case, there was a fall in glucose concentration due to dilution; this was quantitated by chloride space analysis and accounted for 24-34% of the fall in concentration. The size of the glucose pool decreased for two reasons. Glucosuria accounted for the majority of the reduction in the size of the glucose pool in the patients with the smallest decrease in extracellular fluid (ECF) volume [and hence the best preserved glomerular filtration rate (GFR)]. In contrast, glucosuria was a less important factor in causing glucose loss in the patients with very low GFR values. The size of the glucose pool also decreased due to glucose metabolism that did not require exogenous insulin. Thus the fall in glucose concentration in the initial therapy in patients with the hyperglycemic hyperosmolar syndrome is multifactorial and is not absolutely dependent on exogenous insulin. Furthermore, the patients grouped in this diagnostic category represent a heterogeneous population with the comm...Continue Reading

Citations

Dec 1, 1989·Diabetes/metabolism Reviews·M WalkerK G Alberti
Jan 10, 2001·Endocrinology and Metabolism Clinics of North America·M F DelaneyW M Kettyle
Dec 1, 2001·Endocrinology and Metabolism Clinics of North America·D L Trence, I B Hirsch
Dec 1, 1990·Australian and New Zealand Journal of Medicine·P S HamblinJ R Stockigt
Sep 3, 2013·Current Emergency and Hospital Medicine Reports·William FordCandace D McNaughton
Jun 12, 2013·The Veterinary Clinics of North America. Small Animal Practice·Amie Koenig
Nov 3, 2010·The Journal of Pediatrics·Phil ZeitlerUNKNOWN Drugs and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society
May 1, 1990·The American Journal of Medicine·K S KamelM L Halperin
Jun 29, 2005·Emergency Medicine Clinics of North America·Michelle A Charfen, Madonna Fernández-Frackelton
Aug 17, 2004·The Medical Clinics of North America·Jason L GagliaMartin J Abrahamson
Feb 24, 2001·Diabetes Care·A E KitabchiB M Wall
Nov 3, 2017·Pediatric Emergency Care·Randall Yimbong ChanCynthia H Ho
May 1, 2007·British Journal of Hospital Medicine·V Sharma, N Hadebe
Apr 1, 1987·Scottish Medical Journal·M Small, A C MacCuish

❮ Previous
Next ❯

Related Concepts

Related Feeds

American Diabetes Association Journals

Discover the latest diabetes research published by the journals from the American Diabetes Association.