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October 10, 2005

Hyperglycemia and DKA, Other

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Question from Illinois, USA:

I read an article about hyperglycemia being a cause of seizure. Can a seizure be interpreted as a safeguard, in other words, an internal mechanism telling the body it’s in trouble? Where can I find more information?

Answer:

From: DTeam Staff

I have never (knowingly) seen and am not aware that hyperglycemia, per se, “causes” seizures.

A convulsion typically leads to some minor breakdown of skeletal muscle which will also have led to some increase in the serum glucose. In addition, the extra adrenaline and cortisol made during a convulsion can lead to higher glucose levels. So, a convulsion can lead to higher glucoses, not typically the other way around.

On the other hand, with SEVERELY elevated glucose levels (e.g. over 800 mg/dL [44.4 mmol/L]), there can be sluggish blood flow to the brain and this can lead to changes in level of consciousness or, perhaps, a seizure. It is not the high blood glucose directly, but rather the affect upon blood and nutrient flow to the brain.

For people who have diabetes and have marked increases in glucose, this same principle applies. Again, they typically do NOT have seizures, but can have diminished levels of alertness. In fact, too rapid lowering of the glucose can be dangerous also and could be associated with brain swelling, damage, etc., which could lead to serious altered levels of awareness and possibly convulsions.

DS