Chandan Kamath
United Kingdom
Case Report
Severe Refractory Hypoglycaemia in an Acutely Ill Elderly Man with Type 2 Diabetes Mellitus
Author(s): Jyothish Govindan, Inder Singh, Chandan Kamath, Aoife Gleeson, Mohamed A Adlan and Lakdasa D PremawardhanaJyothish Govindan, Inder Singh, Chandan Kamath, Aoife Gleeson, Mohamed A Adlan and Lakdasa D Premawardhana
Background: Hypoglycaemia in elderly Type 2 diabetes mellitus (T2DM) patients causes significant morbidity as the elderly are more prone to the effects of neuroglycopenia and are unable to mount a rapid and effective counter response. Rarely an insulinoma may occur in elderly T2DM subjects and may cause refactory hypoglycaemia.
Case report and management: An octagenarian man with T2DM, Parkinson’s disease and atrial fibrillation was admitted with leg cellulitis and was treated appropriately. He then developed Klebsiella pneumoniae pneumonia and septicaemia and an acute coronary syndrome. However his stay in hospital was characterized by multiple, frequent, symptomatic and distressing hypoglycaemia requiring ferquent intravenous glucose.
Elevated serum insulin and C peptide levels during hypoglycaemia (plasma glucose 1.8 mmol/l), high chromogranin A, and a 2.5 cm .. View More»
