Dijete sa životno ugrožavajućom hipoglikemijom

master's thesis

• Title (english): Life-threatening hypoglycemia in children
• Author: Maja Dupček
• Mentor: Mario Ćuk (mentor)
• Committee member: Danko Milošević (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Mario Ćuk (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Hipoglikemija (od starogrčkog ὑπογλυκαιμία, hypo-, glykys, -haima) označava nisku razinu šećera u krvi. Čest je klinički problem u novorođenčadi, manje učestao u dojenčadi i rijedak u starije djece. Mogu ju uzrokovati razna stanja. Najčešći uzrok jake hipoglikemije u djetinjstvu je kongenitalni hiperinzulinizam. Simptomi hipoglikemije ovise o životnoj dobi djeteta, o brzini kojom se ona razvija, o uzroku odnosno popratnim simptomima bolesti koja je uzrok hipoglikemije i individualnoj osjetljivosti na hipoglikemiju. Novorođenčad i dojenčad s asimptomatskom ili simptomatskom hipoglikemijom mogu imati neurokognitivne poremećaje u vrijeme hipoglikemije ili nakon. Anamneza, status i neki klinički i biološki testovi mogu dovesti do dijagnoze u većine pacijenata koji se prezentiraju s hipoglikemijom. Sposobnost ispravnog razvrstavanja diferencijalnih dijagnoza hipoglikemije ovisi o dobivanju uzorka krvi u vrijeme hipoglikemije. Ovaj uzorak koristi se za mjerenje raznih metaboličkih prekursora i hormona uključenih u regulaciju glukoze, uključujući glukozu, inzulin, hormon rasta, kortizol, laktat, piruvat, beta-hidroksibutirat, slobodne masne kiseline, karnitin i C-peptid. Kratkoročno liječenje hipoglikemije sastoji se od intravenskog bolusa glukoze 10% 2,5 mL/ kg. Nakon primjene bolusa, IV infuziju glukoze treba nastaviti. To bi se trebalo prilagoditi za održavanje razine glukoze u plazmi na više od 3 mmol / L.

Abstract (english)

Hypoglycemia (from ancient Greek ὑπογλυκαιμία, hypo-, glykys, -haima) means low blood sugar. It is a common clinical problem in neonates, less common in infants, and rare in older children. It can be caused by various conditions. The most common cause of severe hypoglycemia in childhood is congenital hyperinsulinism. Symptoms of hypoglycemia depend on the age of the child, the rate at which it develops, the cause or the accompanying symptoms of the disease that causes the hypoglycemia and the individual susceptibility to hypoglycemia. Infants and children with asymptomatic or symptomatic hypoglycemia have been shown to have neurocognitive defects at the time of hypoglycemia. The clinical history, examination and some simple clinical and biological tests may allow diagnosing the vast majority of patients presenting with hypoglycaemia. The ability to properly sort through the differential diagnosis of hypoglycemia depends on obtaining a blood sample at the time of hypoglycemia. This sample is used to measure the various metabolic precursors and hormones involved in glucose regulation, including glucose, insulin, growth hormone, cortisol, lactate, pyruvate, beta-hydroxybutyrate, free fatty acid, carnitine and C-peptide. Short-term treatment of hypoglycemia consists of an intravenous bolus of glucose 10% 2.5 mL/kg. After the bolus is administered, an IV infusion should be continued. This should be adjusted to maintain the plasma glucose level at more than 3 mmol/L.

• Keywords: hipoglikemija; glukoza; dijagnoza; liječenje
• Keywords (english): hypoglycemia; glucosis; diagnosis; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:161306
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-12-28 11:06:12