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Hypoglykämie trotz Hyperglykämie

Ist eine zerebrale Minderversorgung mit Glukose auch bei erhöhtem Blutzuckerspiegel möglich?

Hypoglycemia despite hyperglycemia

Is a cerebral glucose deficiency possible even with raised blood sugar levels?

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Zusammenfassung

Hypoglykämien stellen den häufigsten endokrinologischen Notfall in der prähospitalen Patientenversorgung dar. Da die Erkrankten bei Ankunft des Notarztes meist bewusstseinsgestört sind, ist eine Diagnosesicherung häufig allein durch Bestimmung des Blutglukosespiegels möglich. Selbst bei normo- bzw. hyperglykämischen Messergebnissen kann eine stattgehabte Hypoglykämie als Ursache eines akuten zerebralen Defizits nicht mit Sicherheit ausgeschlossen werden und muss, besonders bei insulinpflichtigen Diabetes-mellitus-Patienten, differenzialdiagnostisch erwogen werden. Wir berichten über die notärztliche Diagnosestellung und Therapie einer hypoglykämischen Episode einer Patientin mit prolongierter Neuroglykopenie bei gleichzeitig vorliegender zerebrovaskulärer Demenz und Morbus Alzheimer.

Abstract

Hypoglycemia represents the most frequent endocrinologic emergency situation in prehospital patient care. As the patients are usually unconscious on arrival of emergency medical personnel, often the only way to establish a diagnosis is by determination of the blood glucose concentration. However, even normoglycemic or hyperglycemic levels cannot definitively exclude the diagnosis of a previous hypoglycemia as the cause of the acute cerebral deficiency. Therefore, and especially in the case of insulin-dependent diabetes mellitus, a differential diagnosis should be considered. We report a case of emergency treatment of a hypoglycemic episode in a female patient with prolonged neuroglycopenia together with cerebrovascular dementia and Alzheimer’s disease.

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Erdös, G., Lobmann, R., Wolcke, B. et al. Hypoglykämie trotz Hyperglykämie. Anaesthesist 54, 673–678 (2005). https://doi.org/10.1007/s00101-005-0825-2

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  • DOI: https://doi.org/10.1007/s00101-005-0825-2

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