{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T10:49:15Z","timestamp":1774781355034,"version":"3.50.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Hypoglycemia is a common occurrence in diabetic patients. But unlike non diabetic patients, its causes are frequently related to drugs they are receiving to control blood glucose. But this may not always be the case. Here we report a type 2 diabetic patient with severe hypoglycemia owing to acute hypopituitarism secondary to pituitary apoplexy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 45\u00a0year old male diabetic patient from Ethiopia taking 2\u00a0mg of oral glimepiride daily who presented with change in mentation of 30\u00a0minutes and blood glucose recording of 38\u00a0mg\/dl upon arrival to the emergency room. Brain magnetic resonance imaging showed pituitary macroadenoma with hemorrhage suggestive of pituitary apoplexy. Blood work up showed low adrenocorticotropic hormone, cortisol, and serum sodium levels. Subsequently transsphenoidal hypophysectomy was done.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The occurrence of hypoglycemia in a diabetic patient taking sulphonylurea monotherapy is common. But when it is severe enough to cause altered mentation, patients should be approached differently. In the presence of clinical clues suggesting cortisol deficiency, hypopituitarism can be a possible cause.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04642-9","type":"journal-article","created":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T01:10:30Z","timestamp":1722474630000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Severe hypoglycemia in a diabetic patient with pituitary apoplexy: a case report"],"prefix":"10.1186","volume":"18","author":[{"given":"Binyam Melese","family":"Getahun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Medhanet Azene","family":"Gebeyehu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amsalu Molla","family":"Getahun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4987-9103","authenticated-orcid":false,"given":"Yoseph Gebremedhin","family":"Kassie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,1]]},"reference":[{"key":"4642_CR1","doi-asserted-by":"publisher","first-page":"S104","DOI":"10.1016\/j.jcjd.2017.10.010","volume":"42","author":"JF Yale","year":"2018","unstructured":"Yale JF, Paty B, Senior PA. Hypoglycemia. Can J Diabetes. 2018;42:S104\u20138.","journal-title":"Can J Diabetes"},{"issue":"5","key":"4642_CR2","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.2337\/dc12-2480","volume":"36","author":"ER Seaquist","year":"2013","unstructured":"Seaquist ER, Anderson J, Childs B, Cryer P, Dagogo-Jack S, Fish L, et al. Hypoglycemia and diabetes: a report of aworkgroup of the American diabetes association and the endocrine society. Diabetes Care. 2013;36(5):1384\u201395.","journal-title":"Diabetes Care"},{"key":"4642_CR3","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1007\/978-1-4939-2895-8_11","volume":"872","author":"AC Geraghty","year":"2015","unstructured":"Geraghty AC, Kaufer D. Glucocorticoid signaling. Adv Exp Med Biol. 2015;872:253\u201378.","journal-title":"Adv Exp Med Biol"},{"issue":"Suppl 3","key":"4642_CR4","first-page":"S188","volume":"15","author":"S Ranabir","year":"2011","unstructured":"Ranabir S, Baruah MP. Review article: pituitary apoplexy. Indian J Endocrinol Metab. 2011;15(Suppl 3):S188\u201396.","journal-title":"Indian J Endocrinol Metab"},{"issue":"6","key":"4642_CR5","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1210\/er.2015-1042","volume":"36","author":"C Briet","year":"2015","unstructured":"Briet C, Salenave S, Bonneville JF, Laws ER, Chanson P. Pituitary apoplexy. Endocr Rev. 2015;36(6):622\u201345.","journal-title":"Endocr Rev"},{"issue":"1","key":"4642_CR6","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1002\/dmrr.2470","volume":"30","author":"JE Schopman","year":"2014","unstructured":"Schopman JE, Simon ACR, Hoefnagel SJM, Hoekstra JBL, Scholten RJPM, Holleman F. The incidence of mild and severe hypoglycaemia in patients with type 2 diabetes mellitus treated with sulfonylureas: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2014;30(1):11\u201322.","journal-title":"Diabetes Metab Res Rev"},{"issue":"30","key":"4642_CR7","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1002\/dmrr.2514","volume":"32","author":"S Balducci","year":"2014","unstructured":"Balducci S, Sacchetti M, Haxhi J, Orlando G, D\u2019Errico V, Fallucca S, Menini S, Pugliese G. Physical exercise as therapy for type II diabetes. Diabetes Metab Res Rev. 2014;32(30):13\u201323.","journal-title":"Diabetes Metab Res Rev"},{"issue":"4","key":"4642_CR8","doi-asserted-by":"publisher","first-page":"286","DOI":"10.14740\/jocmr2041w","volume":"7","author":"N Jessani","year":"2015","unstructured":"Jessani N, Jehangir W, Behman D, Yousif A, Spiler IJ. Secondary adrenal insufficiency: an overlooked cause of hyponatremia. J Clin Med Res. 2015;7(4):286\u20138.","journal-title":"J Clin Med Res"},{"key":"4642_CR9","unstructured":"Theoretical PI, By GIT, Yarrow RS. Downloaded from https:\/\/royalsocietypublishing.org\/ on 14 March 2024 Downloaded from https:\/\/royalsocietypublishing.org\/ on 14 March 2024. 1934;538(1932):362\u201387."},{"issue":"3","key":"4642_CR10","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1097\/00007611-192303000-00001","volume":"16","author":"ML Graves","year":"1923","unstructured":"Graves ML. Clinical studies. South Med J. 1923;16(3):151\u201360.","journal-title":"South Med J"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04642-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04642-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04642-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T01:12:08Z","timestamp":1722474728000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04642-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,1]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4642"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04642-9","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,1]]},"assertion":[{"value":"4 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Institutional approval is not required to publish the case details.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declared no potential conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"349"}}