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Published in: International Journal of Emergency Medicine 1/2011

Open Access 01-12-2011 | Brief Research Report

Alcohol-related hypoglycemia in rural Uganda: socioeconomic and physiologic contrasts

Authors: Heather Hammerstedt, Stacey L Chamberlain, Sara W Nelson, Mark C Bisanzo

Published in: International Journal of Emergency Medicine | Issue 1/2011

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Abstract

Hypoglycemia is a rare but important complication seen in patients who present with alcohol intoxication. In a study by Marks and Teale, less than one percent of people with alcohol intoxication who presented to an American emergency department were hypoglycemic [1]. It is even more rare to see an intoxicated patient, who had been eating appropriately prior to or during the intoxication, present in a hypoglycemic coma. However, our analysis of the first 500 patients seen in a newly opened five-bed Emergency Department (ED) at Nyakibale Karoli Lwanga Hospital in rural southwestern Uganda, revealed multiple intoxicated patients who presented in hypoglycemic coma within hours of eating a full meal. Three of these cases are summarized and discussed below.
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Literature
1.
go back to reference Marks V, Teale JD: Drug induced hypoglycemia. Endocrinology Metab Clin North Am 1999, 28: 555–577. 10.1016/S0889-8529(05)70088-8CrossRef Marks V, Teale JD: Drug induced hypoglycemia. Endocrinology Metab Clin North Am 1999, 28: 555–577. 10.1016/S0889-8529(05)70088-8CrossRef
2.
go back to reference Duffens K, Marx JA: Alcoholic ketoacidosis--a review. J Emerg Med 1987, 5(5):399–406. 10.1016/0736-4679(87)90146-6CrossRefPubMed Duffens K, Marx JA: Alcoholic ketoacidosis--a review. J Emerg Med 1987, 5(5):399–406. 10.1016/0736-4679(87)90146-6CrossRefPubMed
3.
go back to reference Williams HE: Alcoholic hypoglycemia and ketoacidosis. Med Clin North Am 1984, 68(1):33–8.PubMed Williams HE: Alcoholic hypoglycemia and ketoacidosis. Med Clin North Am 1984, 68(1):33–8.PubMed
4.
go back to reference Jain H, Beriwal S, Singh S: Alcohol induced ketoacidosis, severe hypoglycemia and irreversible encephalopathy. Med Sci Monit 2002, 8(11):CS77–9.PubMed Jain H, Beriwal S, Singh S: Alcohol induced ketoacidosis, severe hypoglycemia and irreversible encephalopathy. Med Sci Monit 2002, 8(11):CS77–9.PubMed
5.
go back to reference Marinella MA: Alcoholic ketoacidosis presenting with extreme hypoglycemia. Am J Emerg Med 1997, 15(3):280–1. 10.1016/S0735-6757(97)90015-2CrossRefPubMed Marinella MA: Alcoholic ketoacidosis presenting with extreme hypoglycemia. Am J Emerg Med 1997, 15(3):280–1. 10.1016/S0735-6757(97)90015-2CrossRefPubMed
6.
go back to reference Mendoza A, Kim YN, Chernoff A: Hypoglycemia in hospitalized adult patients without diabetes. Endocr Pract 2005, 11(2):91–6.CrossRefPubMed Mendoza A, Kim YN, Chernoff A: Hypoglycemia in hospitalized adult patients without diabetes. Endocr Pract 2005, 11(2):91–6.CrossRefPubMed
7.
go back to reference Glaser B, Leibowitz G: Hypoglycemia. In Joslin's Diabetes Mellitus. Volume 14. Edited by: Kahn CR, Weir G, King G, et al. New York: Lippincott, Williams, & Wilkins; 2004:1153–1154. Glaser B, Leibowitz G: Hypoglycemia. In Joslin's Diabetes Mellitus. Volume 14. Edited by: Kahn CR, Weir G, King G, et al. New York: Lippincott, Williams, & Wilkins; 2004:1153–1154.
8.
go back to reference Stubbs M, Veech RL, Krebs HA: Control of the redox state of the nicotinamide-adenine dinucleotide couple in rat liver cytoplasm. Biochem J 1972, 126: 59–65.PubMedCentralCrossRefPubMed Stubbs M, Veech RL, Krebs HA: Control of the redox state of the nicotinamide-adenine dinucleotide couple in rat liver cytoplasm. Biochem J 1972, 126: 59–65.PubMedCentralCrossRefPubMed
9.
go back to reference Dittmar EA, Hetenyi G Jr: The effect of ethanol on glucose homeostasis. Can J Physiol Pharmacol 1978, 56(1):54–61.CrossRefPubMed Dittmar EA, Hetenyi G Jr: The effect of ethanol on glucose homeostasis. Can J Physiol Pharmacol 1978, 56(1):54–61.CrossRefPubMed
11.
go back to reference Huang Z, Sjöholm A: Ethanol acutely stimulates islet blood flow, amplifies insulin secretion, and induces hypoglycemia via nitric oxide and vagally mediated mechanisms. Endocrinology 2008, 149: 232–236. 10.1210/en.2007-0632CrossRefPubMed Huang Z, Sjöholm A: Ethanol acutely stimulates islet blood flow, amplifies insulin secretion, and induces hypoglycemia via nitric oxide and vagally mediated mechanisms. Endocrinology 2008, 149: 232–236. 10.1210/en.2007-0632CrossRefPubMed
12.
go back to reference Madison LL: Ethanol Induced Hypoglycemia. In Advances in Metabolic Disorders (version 3). New York: Academic Press; 1968:85–109. Madison LL: Ethanol Induced Hypoglycemia. In Advances in Metabolic Disorders (version 3). New York: Academic Press; 1968:85–109.
13.
go back to reference Ejilemele AA, Orluwene CG: Biochemical changes in chronic alcoholics in Port Harcourt: the report of a pilot survey. Niger Postgrad Med J 2010, 17(2):154–9.PubMed Ejilemele AA, Orluwene CG: Biochemical changes in chronic alcoholics in Port Harcourt: the report of a pilot survey. Niger Postgrad Med J 2010, 17(2):154–9.PubMed
Metadata
Title
Alcohol-related hypoglycemia in rural Uganda: socioeconomic and physiologic contrasts
Authors
Heather Hammerstedt
Stacey L Chamberlain
Sara W Nelson
Mark C Bisanzo
Publication date
01-12-2011
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Emergency Medicine / Issue 1/2011
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI
https://doi.org/10.1186/1865-1380-4-5

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