Neurogenic hyperglycemia

Neurogenic hyperglycemia is manifested by an increase in blood sugar levels. May be accompanied by hyperglycemic coma. Hyperglycemia is usually accompanied by glucosuria. Patients often complain of thirst. Polydipsia, polyuria, pruritus are detected.

[1], [2], [3], [4], [5], [6], [7]

Causes of the neurogenic hyperglycemia

Neurogenic hyperglycemia, or "stress diabetes," can be caused by various factors leading to increased secretion of cortisol, glucagon, catecholamines, growth hormone, which contributes to impaired secretion and insulin action. Acute changes in the regulatory hypothalamic-pituitary system are most often observed during periods of stress: hypothermia, general anesthesia, severe and extensive traumatic injuries, sepsis, extensive body burns, acute emotional stress. It can be observed in case of severe damage to the skull, cerebral thrombosis, encephalitis, heat stroke.

[8], [9], [10]

Pathogenesis

The basis of the pathological condition is a decrease in the level of insulin, an increase in the concentration of glucagon, catecholamines, cortisol, ACTH, growth hormone.

Decreased insulin levels are usually the result of a previous increase in the level of contrainsular hormones. The effect of an increase in blood glucose should be called a multi-hormonal reaction. The hypothalamic control of carbohydrate metabolism, which is mediated through vegetative (sympathetic activation) and neurohormonal links, changes.

[11], [12], [13], [14]

Differential diagnosis

The differential diagnosis should be made with diabetes mellitus, hormonal disorders with excessive secretion of contra-insular hormones in the framework of the syndrome and Itsenko-Cushing's disease, acromegaly, pheochromocytoma. Hyperglycemia may be accompanied by a number of complex genetic syndromes such as ataxia telangiectasia, Lawrence syndrome - Moon - Bardet -. Biedl, atrophic myotonia, Friedreich's ataxia, and others should not forget the possibility of dosage hyperglycemia when applying outputting potassium diuretics contrainsular hormones, psychotropic means.

[15], [16], [17], [18], [19], [20]

Treatment of the neurogenic hyperglycemia

It is considered an effective approach to the elimination of neurogenic hyperglycemia through the blockade of peripheral alpha-adrenoreceptors. For this purpose, alpha-adrenergic blockers are used - phentolamine, 0.025 g, 4 times a day, or pyrroxane, 0.015 g, 4 times a day. Both drugs enhance insulin secretion, thus normalizing blood sugar levels. However, specific therapeutic tactics are under development. Possible to receive various hypoglycemic agents.