title: Full neurological recovery after extreme hypoglycemia during intensive insulin therapy: a case report.
abstract: Since 2000, there has been an ongoing debate regarding tightness of glycemic control in critically ill patients. An increased risk of hypoglycemia is observed in patients treated with an intensive insulin protocol targeting "normoglycemia," probably accounting for a reduction of the overall benefit. Hypoglycemia is associated with neurological side effects and is found to be an independent predictor of mortality in most trials; however, long-term sequelae are rare if glucose is administered early. We describe a case of prolonged, extreme hypoglycemia in a critically ill patient treated according to an intensive insulin protocol who recovered without any neurological deficit at discharge.
authors.affiliation: Department of Anesthesiology and Intensive Care, Catharina Ziekenhuis, Eindhoven, The Netherlands. Veerle_Piot@hotmail.com
authors.forename: Veerle M
authors.initials: VM
authors.lastname: Piot
authors.forename: Anton
authors.initials: A
authors.lastname: Verrijcken
authors.forename: Marc
authors.initials: M
authors.lastname: Vanhoof
authors.forename: Ilse
authors.initials: I
authors.lastname: Mertens
authors.forename: Filiep
authors.initials: F
authors.lastname: Soetens
mesh_terms: D000328:Adult; D016638:Critical Illness / Q000534:rehabilitation / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D003929:Diabetic Neuropathies / Q000139:chemically induced / Q000534:rehabilitation*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000534:rehabilitation*; D007328:Insulin / Q000009:adverse effects* / Q000627:therapeutic use; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000628:therapy; D020127:Recovery of Function / Q000502:physiology; D012720:Severity of Illness Index
chemical_list: D007328:Insulin