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...
Main Authors: | , , , , , , |
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Format: | Article |
Language: | English |
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SAGE Publishing
2020-07-01
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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. |
first_indexed | 2024-12-16T18:38:40Z |
format | Article |
id | doaj.art-1c6d6799436849c2a57852df7fd270e6 |
institution | Directory Open Access Journal |
issn | 2042-0196 |
language | English |
last_indexed | 2024-12-16T18:38:40Z |
publishDate | 2020-07-01 |
publisher | SAGE Publishing |
record_format | Article |
series | Therapeutic Advances in Endocrinology and Metabolism |
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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