Hypoglycemia as a Pathological Result in Medical Praxis
2011
Maintenance of blood glucose homeostasis is fundamentally important for health. The maintain of stable levels of glucose in the blood is one of the most finely regulated of all homeostatic mechanisms and one in which the liver, the extrahepatic tissues, and several hormones play a part. Even mild disruptions of glucose homeostasis can have adverse consequences. The physiological post absorptive serum glucose concentration in healthy humans range is 4, 4-5,8 mmol/L (80 to 105 mg/dL). The stability of the plasma glucose level is a reflection of the balance between the rates of whole body glucose production and glucose utilization. Generally, hypoglycemia is defined as a serum glucose level below 3. 8 mmol/L (70 mg/dL).As a relatively rare disorder, hypoglycemia most often affects those humans at the extremes of age, such as infants and the elderly, but may happen at any age. As a medical problem, hypoglycemia is diagnosed by the presence of three key features (known as Whipple's triad). Whipple's triad is: 1. symptoms consistent with hypoglycemia, 2. a low plasma glucose concentration, and 3. relief of symptoms after the plasma glucose level is raised. The etiology of hypoglycemia is numerous: 1. Inborn error of metabolism (more common in the pediatric patient than in adults). Disturbance in carbohydrates metabolism: Malabsorption of glucose/galactose, alactasia, asucrasia, galactosemia, fructose intolerance. Glycogen storage disease, Type I ,or von Gierke Disease, glycogen storage disease, Type III, a deficiency of glycogen disbranching enzyme activity ( limit dextrinosis), Type VI glycogen storage disease, a deficiency of liver phosphorylase ) 2. Hormonal disturbance .The hormone insulin plays a central role in the regulation of the blood glucose concentration. It is produced by the cells of islets of Langerhance in the pancreas. Insulin exerts hypoglycemic effect. Glucagon is the hormone produced by the
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