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Endocrinol Metab : Endocrinology and Metabolism



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Case Report A Case of Masked Hypoglycemia during Lactic Acidosis.
Hee Seon Kim, Ho Sung Yoon, Chang Ok Koh, Hyeon Kyu Kim, Choel Young Park, Seong Jin Lee, Gi Weon Oh, In Kyung Jeong, Eun Gyung Hong, Cheol Soo Choi, Doo Man Kim, Sung Hee Ihm, Jae Myung Yu, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park, Dong Jin Oh
Endocrinology and Metabolism 2004;19(4):406-410

Published online: August 1, 2004
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Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon, Korea.

Severe hypoglycemia induces neuroglycopenic symptoms, including mental alteration, as glucose is the exclusive fuel for the central nervous system. However, some reports have shown that non-glucose fuels, like lactates and ketones, could be utilized by the brain during severe hypoglycemia. Herein, a case of extreme hypoglycemia in a 44-year old woman, subsequently diagnosed as congestive heart failure accompanied by ischemic hepatitis and lactic acidosis, is presented. In two episodes of extreme hypoglycemia, she was fully alert without obvious neurological deficits. In this unusual case, an increased supply of lactate might have maintained the cerebral function and prevented cerebral injury during the hypoglycemia that was induced as a result of starvation and hepatic and cardiac dysfunctions

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