Hyperglycemia-induced seizures and blindness

The complex landscape of intracellular signalling in protein modification under hyperglycaemic stress leading to metabolic disorders

Hyperglycaemia is a life-threatening risk factor that occurs in both chronic and acute phases and has been linked to causing injury to many organs. Protein modification was triggered by hyperglycaemic stress, which resulted in pathogenic alterations such as impaired cellular function and tissue damage. Dysregulation in cellular function increases the condition associated with metabolic disorders, including cardiovascular diseases, nephropathy, retinopathy, and neuropathy. Hyperglycaemic stress also increases the proliferation of cancer cells. The major areas of experimental biomedical research have focused on the underlying mechanisms involved in the cellular signalling systems involved in diabetes-associated chronic hyperglycaemia. Reactive oxygen species and oxidative stress generated by hyperglycaemia modify many intracellular signalling pathways that result in insulin resistance and β-cell function degradation. The dysregulation of post translational modification in β cells is clinically associated with the development of diabetes mellitus and its associated diseases. This review will discuss the effect of hyperglycaemic stress on protein modification and the cellular signalling involved in it. The focus will be on the significant molecular changes associated with severe metabolic disorders.

Case Report: Abruptio placentae and epileptic seizure after occurrence of perinatal hyperglycaemia in woman with gestational diabetes mellitus and hypertriglyceridemia-induced acute pancreatitis

Hypertriglyceridemia-induced acute pancreatitis seldom occurs in the second trimester of pregnancy with gestational diabetes mellitus. For these patients, the existing knowledge on concomitant hyperglycemia is not sufficient. We report a case of abruptio placentae and epileptic seizure following perinatal hyperglycaemia in woman with gestational diabetes mellitus and hypertriglyceridemia-induced acute pancreatitis. The occurrence of abruptio placentae and epileptic seizure may be associated with concomitant hyperglycemia, and the epileptic seizure was terminated after she underwent treatment with insulin. We should pay more attention to the adverse effects of perinatal hyperglycemia and continue to give appropriate insulin treatment even if patients have passed the acute phase of hypertriglyceridemia-induced acute pancreatitis.

Oxidative stress: a common imbalance in diabetes and epilepsy

The brain requires a large amount of energy. Its function can be altered when energy demand exceeds supply or during metabolic disturbances such as diabetes mellitus. Diabetes, a chronic disease with a high incidence worldwide, is characterized by high glucose levels (hyperglycemia); however, hypoglycemic states may also occur due to insulin treatment or poor control of the disease. These alterations in glucose levels affect the brain and could cause epileptic seizures and status epilepticus. In addition, it is known that oxidative stress states emerge as diabetes progresses, contributing to the development of diseases secondary to diabetes, including retinopathy, nephropathy, cardiovascular alterations, and alterations in the central nervous system, such as epileptic seizures. Seizures are a complex of transient signs and symptoms resulting from abnormal, simultaneous, and excessive activity of a population of neurons, and they can be both a cause and a consequence of oxidative stress. This review aims to outline studies linking diabetes mellitus and seizures to oxidative stress, a condition that may be relevant to the development of severe seizures in diabetes mellitus patients.

Epileptic seizures during Non-Ketotic Hyperglycemia (NKH) in French Guiana: A retrospective study

INTRODUCTION

Epileptic seizures during non-ketotic hyperglycemia (NKH) represent a rare complication of uncontrolled diabetes mellitus. The definition associates a blood sugar level > 200mg/dL (11mmol/L), hyperosmolality, absence of ketosis, dehydration and seizure control after normalization of blood sugar levels.

MATERIAL AND METHODS

This retrospective observational study included patients hospitalized for epileptic seizures and NKH in the Cayenne Hospital Center between January 2010 and June 2020. The clinical, biological, and radiological results were collected.

RESULTS

18 out of 228 (7.9%) patients with both diabetes and epileptic seizures had NKH. The mean age of the 12 women and 6 men was 64.8 years. In 8 patients, brain imaging did not show acute lesions and the seizures disappeared with control of hyperglycemia by hydration and insulin. In 6 patients, the seizures revealed a stroke, hemorrhagic in 4 cases, ischemic in 2 cases. 4 patients had a seizure in a context of known vascular epilepsy. The epileptic seizures were mainly focal seizures with motor symptoms that could be repeated, focal to bilateral tonic-clonic or focal status.

CONCLUSION

Seizures in NKH are symptomatic of an acute brain lesion or vascular epilepsy more than 1 in 2 times. However, isolated NKH can cause seizures with a suggestive brain MRI.