A Case of Hyperglycemic Hyperosmolar State Associated with Graves' Hyperthyroidism: A Case Report
Journal of Korean Medical Science
; : 765-767, 2006.
Article
in En
| WPRIM
| ID: wpr-211992
Responsible library:
WPRO
ABSTRACT
Hyperglycemic hyperosmolar state (HHS) is an acute complication mostly occurring in elderly type 2 diabetes mellitus (DM). Thyrotoxicosis causes dramatic increase of glycogen degradation and/or gluconeogenesis and enhances breakdown of triglyc-erides. Thus, in general, it augments glucose intolerance in diabetic patients. A 23-yr-old female patient with Graves' disease and type 2 DM, complying with methimazole and insulin injection, had symptoms of nausea, polyuria and generalized weakness. Her serum glucose and osmolarity were 32.7 mM/L, and 321 mosm/kg, respectively. Thyroid function tests revealed that she had more aggravated hyperthyroid status; 0.01 mU/L TSH and 2.78 pM/L free T3 (reference range, 0.17-4.05, 0.31-0.62, respectively) than when she was discharged two weeks before (0.12 mU/L TSH and 1.41 pM/L free T3). Being diagnosed as HHS and refractory Graves' hyperthyroidism, she was treated successfully with intravenous fluids, insulin and high doses of methimazole (90 mg daily). Here, we described the case of a woman with Graves' disease and type 2 DM developing to HHS.
Key words
Full text:
1
Database:
WPRIM
Main subject:
Thyroid Function Tests
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Graves Disease
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Diabetes Mellitus, Type 2
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Fluid Therapy
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Hyperglycemic Hyperosmolar Nonketotic Coma
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Hyperthyroidism
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Insulin
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Methimazole
Limits:
Adult
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Female
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Humans
Language:
En
Journal:
Journal of Korean Medical Science
Year:
2006
Document type:
Article