HYPOGLYCEMIA ( Harison , 1924, Britain) —means any significant decrease in blood sugar below normal levels, below 2.2–2.8 mmol / l. Physiologists Cesky Hypoglycemia occurs when performing heavy physical work, in conditions of hunger.
Pathologists Cesky Hypoglycemia is characterized different tera:
- Caused by hyperinsulinemia ;
- Spontaneous;
- Functional naya;
- Posthyperglycemic ;
- Endocrine:
- Alimentary;
- With dumping syndrome;
- Hepatic
- In patients treated with insulin, often when excreted from a hyperglycemic coma;
- Idiopathic familial;
- If poisoning phosphorus bin zolom, chloroform, hydrazine and other poisons that damage hepatocytes .
- Hypoglycemia motivated hyperinsulinism develops in insulinoma , and very rarely in other OPU holyah, fibrosarcoma , apparently mu producing insulin-like substance.
- Spontaneous hypoglycemia can develop from a number of reasons: functional or neurovegetative, endocrine, alimentary, hepatic, posthyperglycemic , with dumping syndrome, etc.
- Functional or neuro-Vega -commutative Hypoglycemia is more common in asthenic individuals, as well as traumatic or inflammatory lesions of the brain, in particular Nosta stem part. Functional naya hypoglycemia is often manifested in the holo Denmark and neuro-emotional and mental stress. The blood sugar in these fasting .People usually is within the normal range. Hypoglycemia occurs from time to time, sometimes from no perceptible reasons. Frequency Priest dressings depends on the depth of pathological Skog process and functioning of the nervous system. The emotion you normally happens hyperglycemia followed by boiling enhanced secretion of insulin, which in some individuals can lead to hypoglycemia.
- Postgiperglikemicheskaya Hypoglycemia is etsya a form function tional hypoglycemia, herein after ingestion of food rich in carbohydrates, stepping is hyperglycemia, which continued zhaetsya longer and higher than normal, and after a few hours (usual but 1-2 hours), there comes hypoglycemia. This is due yasnyaetsya reaction insular up Paraty on food intake and gipergli kemiyu. Reactive hypoglycemia frequently observed is given in people with asthenic la stably nervous system. This odds ma hypoglycemia sets certain profile or glycemic sugar Noah load.
- Endocrine nature Hypoglycemia IME is place at giiopituitarizme , hypocorticoidism . In these cases, hypoglycemia is permanent with by in relative rare blood sugar fluctuations.
- Hypoglycemia during dumping syndrome fuss repents after 2-3 hours after the meal. The mechanism of hypoglycemia while Ob yasnyaetsya that food remains in the stomach for long and quickly BCA syvayas in the intestines, leading to hyperglycemia, which insular system does not have time to answer the secretion of insulin, and later you scatter insulin leads to hypoglycemia. Hypoglycemia during dumping syndrome as functional Nye form predominantly observed is given in neuro unbalanced people.
- Alimentary Hypoglycemia can develop Xia due to insufficient PRIE food ma, particularly carbohydrates, chronic starvation, alimentar Noah dystrophy, chronic diarrhea, exhaustion.
- Liver Hypoglycemia occurs roofing to atrophy when a guy himy liver, when the latter is unable to deposit the glucose as glycogen enough to lichestve. Liver Hypoglycemia would normally Vaeth lesser degree and is manifested in the increased need for glucose, the liver is unable to provide it due to lack of glucose in its glycogen.
- Among the pathological consisting Nij occurring with hypoglycemia, particularly IU hundred take glycogen congenital nye , metabolic disorders of glycogen and other carbohydrates due to enzyme defects, galactosemia, disease Gierke , Pompe, Forbes , Andersen et al. Hypoglycemia mechanism when glycogen is that due to insufficient enzyme Nosta in children does not occur breakdown and conversion of glycogen into glucose. Gly Cohen accumulates in the liver and leads to hepatomegaly .
- Idiopathic hypoglycemia Family (Mc Curry, 1954, Britain) -neredko meet scheesya hereditary disease. Younger boys often get sick. Noun NOSTA pathology is to slow down the decay of insulin as an effect Wier enzymatic block the insulin-inactivating system ( insulinase ).
- Hypoglycemia in chronic alcoholics cha hundred due gipokortitsizm . In addition, alcohol has the property of lowering blood sugar levels. Not rarely occurs when beremennnosti and in nursing mothers .
- When diabetes often occurs when labile hydrochloric its shape from an overdose of insulin, delayed reception pi soup after injection, and finally by insulin binding to blood proteins and its sudden releasing Nia.
Clinic.
Clinic Hypoglycemia enough character to and is identical in its various forms. The development and intensive Nosta symptoms mainly hang on the degree and rate devel ment of hypoglycemia.
Mild bases GOVERNMENTAL symptoms are paleness, trembling, hunger, weakly Bost, sweating. In the future, the development of hypoglycemia occur Brain symptoms: numbness of the face, of course stey, loss of balance, double vision, and vomiting. A more pronounced ste penalties – seizures, manic with standing, hallucinatory-paranoid episodes, muscle twitching Do ya, grimaces, epileptiform when greedy and finally coma consisting of. However Spontaneous Hypoglycemia not-Euclidean dit to convulsive states and coma.
Hypoglycemic events do not pass without at the consequences, particularly for the central nervous system. The fact that the central nervous system is very sensitive to a deficiency of glucose. Long-term reduction of its leads to serious metabolic changes in the brain, followed by sweat ray memory and decreased intelligence, which in severe cases recovered with difficulty. Repeat nye crises lead to the degradation of the individual. In addition, frequent at the stupa predispose to hypoglycemia appeared novena new.
When Hypoglycemia compensatory mecha us for a short time increase uro Wen blood sugar to normal.
Diencephalic region, one of the regulators of urs nya blood sugar produces STG- RF force vayuschy secretion of growth hormone (STH). Last mobilizing fatty acids from Ms rovyh depot in the liver which pre rotate in glucose. In addition, releasing factor (RF) excites the reticular formation of the brain. SEQ NJ sends nerve momentum sy to the a-cells of the pancreas same lezy and adrenal glands, increased secretion glyukortikosteroidov and adrenaline. These two factors express check ryayut glycogenolysis , gluconeogenesis and quickly raise blood sugar levels.
HYPOGLYCEMIA TREATMENT.
- The treatment of the underlying disease leading to hypoglycemia is pathogenetic.
- Patients with spontaneous hypoglycemia in need of strengthening therapy, medi Noah gymnastics, frequent reception bo Gata protein food.
- In mild hypoglycemic sufficient reception pi soup rich in digestible yz levodami.
- In severe cases administered 10-80 ml of a 40% solution glyu goat w / w, depending on the severity of hypoglycemia.
Hypoglycemia neonates DENNYH.
Hypoglycemia neonates DENNYH – hypoglycemia during the first days of life. Neonatal hypoglycemia before a dysfunction of the placenta, asphyxia at birth, diabetes mother, the latter leads to hyperplasia insular apparatus of the pancreas and fetal giperinsulizmu. Diagnosis of hypoglycemia is set if the blood sugar level is below 30% mg (1.65 mmol / L).
Symptoms
Characterized by cyanosis, tremors, intermittent breathing, poor sucking, rotational movements of the eyeballs, piercing scream.
TREATMENT.
- Oral and within vennoe administering glucose,
- When emphasis GOVERNMENTAL cases – Hydrocortisone 50 mg / kg body weight every 4h.
The forecast is favorable. Neonatal Hypoglycemia about goes after 5-10 days after birth due to the normalization of insular apparatus.