Continuous subcutaneous insulin infusion and flash glucose monitoring in diabetic hemiballism-hemichorea

A 71-year-old man without previous history of diabetes was hospitalized after suffering polyuria for 1 month and involuntary movement of the left arm for 1 week. His random serum glucose was 42.05 mmol/l and his hemoglobin A1C was 14% (129 mmol/mol). His serum osmolarity was normal and his urine ket...

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Main Authors: Wei Qiang, Xia Chen, Chuqi Gao, Zhaoxu Wang, Jin Shang, Jiao Fu, Hui Guo
Format: Article
Language:English
Published: SAGE Publishing 2020-07-01
Series:Therapeutic Advances in Endocrinology and Metabolism
Online Access:https://doi.org/10.1177/2042018820938236
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author Wei Qiang
Xia Chen
Chuqi Gao
Zhaoxu Wang
Jin Shang
Jiao Fu
Hui Guo
author_facet Wei Qiang
Xia Chen
Chuqi Gao
Zhaoxu Wang
Jin Shang
Jiao Fu
Hui Guo
author_sort Wei Qiang
collection DOAJ
description A 71-year-old man without previous history of diabetes was hospitalized after suffering polyuria for 1 month and involuntary movement of the left arm for 1 week. His random serum glucose was 42.05 mmol/l and his hemoglobin A1C was 14% (129 mmol/mol). His serum osmolarity was normal and his urine ketone was negative. Cerebral CT revealed hyperdensity in the right basal ganglia. The patient was diagnosed with diabetic hemiballism-hemichorea (HH). Intravenous insulin was given and later shifted to continuous subcutaneous insulin infusion. During the hospital stay, insulin titration was guided mainly by flash glucose monitoring (FGM). Finger-prick glucose was occasionally checked to verify the accuracy of the FGM. Rapid correction of severe hyperglycemia was achieved without hypoglycemia. HH resolved within 1 week after euglycemia was achieved. This case emphasized the importance of being alert for HH as the initial presentation of diabetes and neuroimaging negative diabetic HH. In addition, interstitial glucose-monitoring technologies including continuous glucose monitoring and FGM can facilitate inpatient intensive insulin therapy in diabetic HH by avoiding hypoglycemia.
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spelling doaj.art-1c6d6799436849c2a57852df7fd270e62022-12-21T22:21:06ZengSAGE PublishingTherapeutic Advances in Endocrinology and Metabolism2042-01962020-07-011110.1177/2042018820938236Continuous subcutaneous insulin infusion and flash glucose monitoring in diabetic hemiballism-hemichoreaWei QiangXia ChenChuqi GaoZhaoxu WangJin ShangJiao FuHui GuoA 71-year-old man without previous history of diabetes was hospitalized after suffering polyuria for 1 month and involuntary movement of the left arm for 1 week. His random serum glucose was 42.05 mmol/l and his hemoglobin A1C was 14% (129 mmol/mol). His serum osmolarity was normal and his urine ketone was negative. Cerebral CT revealed hyperdensity in the right basal ganglia. The patient was diagnosed with diabetic hemiballism-hemichorea (HH). Intravenous insulin was given and later shifted to continuous subcutaneous insulin infusion. During the hospital stay, insulin titration was guided mainly by flash glucose monitoring (FGM). Finger-prick glucose was occasionally checked to verify the accuracy of the FGM. Rapid correction of severe hyperglycemia was achieved without hypoglycemia. HH resolved within 1 week after euglycemia was achieved. This case emphasized the importance of being alert for HH as the initial presentation of diabetes and neuroimaging negative diabetic HH. In addition, interstitial glucose-monitoring technologies including continuous glucose monitoring and FGM can facilitate inpatient intensive insulin therapy in diabetic HH by avoiding hypoglycemia.https://doi.org/10.1177/2042018820938236
spellingShingle Wei Qiang
Xia Chen
Chuqi Gao
Zhaoxu Wang
Jin Shang
Jiao Fu
Hui Guo
Continuous subcutaneous insulin infusion and flash glucose monitoring in diabetic hemiballism-hemichorea
Therapeutic Advances in Endocrinology and Metabolism
title Continuous subcutaneous insulin infusion and flash glucose monitoring in diabetic hemiballism-hemichorea
title_full Continuous subcutaneous insulin infusion and flash glucose monitoring in diabetic hemiballism-hemichorea
title_fullStr Continuous subcutaneous insulin infusion and flash glucose monitoring in diabetic hemiballism-hemichorea
title_full_unstemmed Continuous subcutaneous insulin infusion and flash glucose monitoring in diabetic hemiballism-hemichorea
title_short Continuous subcutaneous insulin infusion and flash glucose monitoring in diabetic hemiballism-hemichorea
title_sort continuous subcutaneous insulin infusion and flash glucose monitoring in diabetic hemiballism hemichorea
url https://doi.org/10.1177/2042018820938236
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