Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Aug 1;18(1):349.
doi: 10.1186/s13256-024-04642-9.

Severe hypoglycemia in a diabetic patient with pituitary apoplexy: a case report

Binyam Melese Getahun  1 , Medhanet Azene Gebeyehu  2 , Amsalu Molla Getahun  3 , Yoseph Gebremedhin Kassie  4
Affiliations
Case Reports

Severe hypoglycemia in a diabetic patient with pituitary apoplexy: a case report

Binyam Melese Getahun et al. J Med Case Rep. .

Abstract

Introduction: Hypoglycemia is a common occurrence in diabetic patients. But unlike non diabetic patients, its causes are frequently related to drugs they are receiving to control blood glucose. But this may not always be the case. Here we report a type 2 diabetic patient with severe hypoglycemia owing to acute hypopituitarism secondary to pituitary apoplexy.

Case presentation: A 45 year old male diabetic patient from Ethiopia taking 2 mg of oral glimepiride daily who presented with change in mentation of 30 minutes and blood glucose recording of 38 mg/dl upon arrival to the emergency room. Brain magnetic resonance imaging showed pituitary macroadenoma with hemorrhage suggestive of pituitary apoplexy. Blood work up showed low adrenocorticotropic hormone, cortisol, and serum sodium levels. Subsequently transsphenoidal hypophysectomy was done.

Conclusion: The occurrence of hypoglycemia in a diabetic patient taking sulphonylurea monotherapy is common. But when it is severe enough to cause altered mentation, patients should be approached differently. In the presence of clinical clues suggesting cortisol deficiency, hypopituitarism can be a possible cause.

Keywords: Case report; Hyponatremia; Pituitary apoplexy; Recurrent hypoglycemia.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
MRI of the brain/Sagital section
Fig. 2
Fig. 2
MRI of the brain/Coronal section
See this image and copyright information in PMC

References

    1. Yale JF, Paty B, Senior PA. Hypoglycemia. Can J Diabetes. 2018;42:S104–8. 10.1016/j.jcjd.2017.10.010 - DOI - PubMed
    1. Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S, Fish L, et al. Hypoglycemia and diabetes: a report of aworkgroup of the American diabetes association and the endocrine society. Diabetes Care. 2013;36(5):1384–95. 10.2337/dc12-2480 - DOI - PMC - PubMed
    1. Geraghty AC, Kaufer D. Glucocorticoid signaling. Adv Exp Med Biol. 2015;872:253–78. 10.1007/978-1-4939-2895-8_11 - DOI - PubMed
    1. Ranabir S, Baruah MP. Review article: pituitary apoplexy. Indian J Endocrinol Metab. 2011;15(Suppl 3):S188–96. - PMC - PubMed
    1. Briet C, Salenave S, Bonneville JF, Laws ER, Chanson P. Pituitary apoplexy. Endocr Rev. 2015;36(6):622–45. 10.1210/er.2015-1042 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources