Hypoglycemia for Biomedical Science - Case Study Example

HYPOGLYCAEMIA: CASE STUDY FOR BIOMEDICAL SCIENCE Hypoglycemia: Case Study for Biomedical Science Hypoglycemia is also known as insulin reaction or insulin shock. It is characterized by abnormal low level of glucose in the blood (Ayoub, Osama & Ismail, 2013 p.847). Under such condition, the level of glucose decreases to less than 70 mg/dl. Hypoglycemic symptoms are clear indications that a person has low levels of blood glucose. It is important to note that reactions to hypoglycemia vary from one person to another. It is important for each individual to understand his or her specific signs when he has low level of glucose in order to seek medical attention (Mohammadreza, 2012 p. 1). It is necessary to test the glucose level in the blood in order to determine whether an individual is suffering from hypoglycemia (Cryer, Axelrod &Grossman 2009 p.709). Specialists argue that it is better to treat hypoglycemia, especially, when individual is experiencing the signs of the disease and cannot verify its presence. Severe hypoglycemia can lead to death, coma, injuries and accidents. True hypoglycemia normally occurs in patients having diabetes type 1 and 2. This is because drugs used for treating diabetes have the ability to lower the level of glucose in the blood (Mohammadreza, 2012 p. 1). The Disease Mechanism A significant proportion of patients suffering from hypoglycemia are unaware of the condition leading to a condition is called Hypoglycemia Unawareness. However, the condition can have a fatal effect on the patient when accompanied by lack of signs. The patient can develop severe hypos when there are no warnings (Cryer, 2004 p. 2273). In this case, warning signs that a patient should eat do not accompany acute drop of glucose. The patients should rely on glucose monitoring equipments and help of others. In a partial loss of hypoglycemia warnings, the patient may experience some signs of hypoglycemia condition though they may not be clear. The other condition is called reduced warning symptoms. In search a scenario, the signs are either missing or reduced though the level of glucose is reduced (Philip, 2013 p.1). The absence of warning can lead to several outcomes. The patient may depend on others and feel insecure. It may also cause embarrassment, especially, when people around an individual known about the condition. Hypoglycemia patients also fear leaving their homes to seek medical attention (Miller et al. 1980 p. 652). Such patients can be a danger to themselves or those around them. For example, hypoglycemia patient can become unconscious when driving. In such case, they can cause a fatal accident. In addition to this, they have a violent and aggressive attitude towards those around them. The condition can also lead to loss of employment and driving license because such patients are regarded as non-performers (Philip 2013 p. 1). Loss of signs in hypoglycemia patients is caused by long time diabetes. In addition to this, hypoglycemia condition can lead to loss of signs and increased incidence of hypos. This in turn forms a continuous vicious circle of hypos. Intensive treatment of diabetes using multi-daily insulin injections that are intended to regulate the level of glucose can cause severe hypoglycemia (Douillard, 2012 p.1). Increased hypoglycemia would encourage loss of signs. It is important to note that loss of hypoglycemia signs can also be caused by neuropathy that is the damage of autonomic nervous system due to diabetes. Lastly, changing insulin species used in regulation of glucose level in the body can also enhance loss of signs among patients experiencing hypoglycemia. It is important for hypoglycemia to verify the glucose level in their blood in order to predict the occurrence of the disease. They should also change their medications, physical activity or meal plan to avoid complication (Philip 2013 p.1). Laboratory Findings An ALT or alanine aminotransferase test determines ALT enzyme level in the blood. Alanine aminotransferase is an enzyme secreted by the liver and enables the body to metabolize proteins. The test is carried out to verify if the liver is functioning (Ayoub, Osama & Ismail 2013 p. 853). None performing liver will encourage the release of ALT into the blood system. From the test, it is correct to deduce that the patient does not have liver problem since the ALT level is within the range. AST test measures the amount of aspartate Aminotransferase enzyme in the blood. Damaged liver or heart causes low level of AST. Under such circumstance, more AST is released in the blood stream. The amount of AST released is directly proportional to the extent of damage on the heart or liver. The test is carried it to determine if a patient is suffering from liver diseases. The patient liver is healthy because AST level is within the normal range. Bilirubin test is conducted to determine the condition of the liver. The test could also be conducted to determine the amount of Red Blood Cells in the blood. It is important to note that RBCs are used for transportation of glucose in the body. It is possible to conclude that the patient’s loss of glucose was not caused by poor means of transfer rather than inadequate glucose in the body. Blood Urea Nitrogen (BUN) test is conducted determine the type of waste product in the body system. It also determines if the kidneys filters waste material correctly (Ayoub, Osama & Ismail 2013 p. 853). The test on the patient indicates that he has a higher level of nitrogenous waste material. It means that the patient consumes more protein than is required or he lacks glucose in the body. Lack of glucose would force the enzymes in liver to break down proteins into amino acid and eventually obtain energy. Such process occurs if an individual is fasting. The results indicate that the patient did not have adequate glucose in the body. This resulted in the breakdown of protein to amino acid. During the breakdown, nitrogenous waste products were released from the liver hence high levels of Urea Nitrogen in the blood. Serum Creatinine is a test done to examine the quantity of creatinine in the blood. It is conducted to examine the functioning of the kidney that removes the creatinine from body system. Increase in creatinine levels in the blood would mean the kidney is not in good condition. A patient with a higher level of creatinine is dehydrated and suffering from diabetes (Cryer et al. 2009 p.725). Creatinine excretion test examines the functioning of Kidney. In addition to this, it can assess renal transplant recipients, modification of treatment for renal excreted complications, monitoring and treating chronic renal diseases (Hickman 2007 p.731). GFR of the patient is low. This has increased the amount of creatinine excretion. High level of the substance may also indicate the kidney of the patient is not functioning properly or the patient is suffering from diabetes mellitus. Insulin test is done to determine the amount of insulin in the blood. Insulin regulates blood sugar level. The patient has elevated insulin level (Ayoub, Osama & Ismail 2013 p. 853). This means he is suffering from type 2 diabetes. That is why there is an increase in level of insulin is intended to increase the amount of glucose. Treatment of Hypoglycemia Hypoglycemia is caused by acute decrease in glucose level in the blood. This is normally caused by side effects of drugs used to treat diabetes. For example, patients who take too much insulin than the level of glucose in their blood would develop the condition, as insulin would reduce glucose level. This explains why most Hypoglycemia patients also suffer from diabetes. Other causes include; excessive consumption of alcohol. For example, too much drinking without taking food can block the liver from secreting stored glucose leading to hypoglycemia. Severe infection of the liver, disorders of the kidney and long-term starvation can also cause hypoglycemia (Sherin, Peeyush &Mathew et al. 2010 p. 23). Hypoglycemia is managed by consuming simple carbohydrates or 15-20 grams of glucose. Patients should also take snacks between meals. Doctors encourage hypoglycemia patients to always pack snacks that contain soda or a half cup of juice, saltine crackers, one tablespoon of honey a few pieces of hard candy and a table spoon of sugar. Patients should be injected with glucagon that would stimulate the liver to discharge stored glucose into the bloodstream (Sherin et al. 2010 p.1). It is also important to notify friends and other concerned persons about one’s conditions. It will empower them to offer care in case one becomes unconscious (Garcia-Compean, Jaquez-Quintana & Hector 2009 p. 1). In addition to this, patients should wear medical identification bracelet which would enable emergency responders attend to a case during an emergency. Patients should also avoid drinks like chocolate, milk and fatty foods because they are absorbed slowly and they do not have adequate sugar (Sherin et al. 2010 p.1). Reference List Ayoub, RA, Osama, S, Ismail, A. (2013) “Effects of Chromium on Some Haemato- Biochemical Parameters in Domestic Rabbits”, International Journal of Biological & Pharmaceutical Research, Vol. 12, no 12, pg 847-854. Cryer, PE, Axelrod, L, Grossman, AB, Heller, SR, Montori, VM, Seaquist, E. (2009), “Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline,” Journal of Clinical Endocrinol Metabolism, Vol. 94, pg 709-728. Cryer, P. (2004) “Diverse causes of hypoglycemia-associated autonomic failure in di abetes,” New England Journal of Medicine, Vol. 350, no. 22, pg. 2272-2279. Douillard, C. (2012) “Hypoglycaemia related to inherited metabolic diseases in adults,” Or phanet Journal of Rare Diseases, vol. 7 no. 26 [online] Available at http://www.ojrd.com/content/7/1/26 [16th March 2014] Garcia-Compean, D, Jaquez-Quintana, OJ & Hector, M. (2009) “Liver cirrhosis and diabetes: Risk factors, pathophysiology, clinical implications and management,” World Journal of Gastroenterology, vol. 15 no. 3 [online] Available http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653324/ [16th March 2014] Hickman, IJ, Macdonald GA 2007, “Impact of diabetes on the severity of liver disease”, American Journal of Medicine, Vol. 120, pg 829–834. Miller, SI, Wallace, RJ, Musher, DM, Septimus, EJ, Kohl, S & Baughn, R. (1980) “Hypoglycemia as a manifestation of sepsis”, The American journal of medicine, Vol. 68, no.5, pg. 649-654. Mohammadreza, M. (2012) “The importance of hypoglycemia in diabetic patients,” Journal of Diabetes & Metabolic Disorders, Vol. 11 no. 17 [online] Available http://www.jdmdonline.com/content/11/1/17 [16th March 2014] Philip E. C. (2013). “Mechanisms of Hypoglycemia-Associated Autonomic Failure in Diabetes,” The New England Journal of Medicine, vol. 10 no. 1056 [Online] Available http://www.nejm.org/doi/full/10.1056/NEJMra1215228#t=article [14 March 2014] Sherin, A. Peeyush, K. Mathew, R.  Anju, T. & Paulose, C. (2010). “Hypoglycemia induced changes in cholinergic receptor expression in the cerebellum of diabetic rats,” Journal of Biomedical Science vol. 17 no. 7 [Online] Available http://www.jbiomedsci.com/content/17/1/7 [14 March 2014] Read More