Hypoglycemias

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ÖN SÖZ
PREFACE
Prof. Dr. Rıfat EMRAL
Ankara Üniversitesi Tıp Fakülesi, Endokrinoloji ve Metabolizma Hastalıkları BD, Ankara, Türkiye
Article Language: TR
Hipoglisemi; plazma glukoz düzeyinin normalin altına indiği ve bunun kişi tarafından gerek otonomik gerekse nöroglukopenik bulguların ortaya çıkışıyla hissedildiği, bulguların dışarıdan glukoz içeren gıdaların alımıyla ortadan kalktığı bir durum olarak tanımlanmaktadır. Her ne kadar hipoglisemi açısından plazma glukoz eşik değeri kişiden kişiye değişse de hipogliseminin organizma için ciddi bir stres koşul olduğu ve bazı durumlarda acil tedavi edilmediğinde ciddi morbidite-mortalite sebebi olduğu iyi bilinmektedir.

Diyabetik bireylerde genellikle tedavinin bir sonucu olarak karşımıza çıkan hipoglisemi, tedavinin yoğunlaştırılmasında da engel bir unsur olabilmekte, hastaların tedavi uyumunu bozabilmekte ve sonuç olarak glisemik regülasyonun iyileştirilmesinde zorluk çıkaran bir faktör hâline gelebilmektedir. Bu da diyabetik bireyin hiperglisemiye bağlı makro- ve mikrovasküler komplikasyonlara maruz kalması açısından önemli bir risk oluşturmaktadır. Bunun ötesinde sık hipoglisemi yaşayan diyabetik bireyler, başkaca birçok komplikasyonlara karşı da korunmasız hâle gelmektedir.

Diyabetik olmayan, dolayısıyla anti-hiperglisemik ajan kullanmayan bireylerde gözlenen hipoglisemi nedenleri ise oldukça geniş bir yelpazeyi oluşturmakta ve hipoglisemi çoğu zaman altta yatan bir başka hastalığın ilk bulgularından biri olabilmektedir. Bazen de farklı nedenlerle kullanılan maddeler, hatta medikal tedavi ajanları, hipogliseminin nedeni olarak karşımıza çıkmaktadır. Dolayısıyla hipoglisemiyi tanımak, ortaya koymak, nedenini tespit etmek ve tedavi etmek, genellikle zorlu bir süreçtir.

Bu kitabın amacı ''Hipoglisemi'' ile ilgili bilgi birikiminin konunun uzmanları tarafından ayrıntılı olarak irdelenmesini sağlayarak, sağlık profesyonellerine ve hekimlere ''Hipoglisemiye Yaklaşım'' ile ilgili kılavuzluğu yapabilmektir. Bu amaçla, bu kitabın hazırlanmasında görev alan tüm meslektaşlarıma ve Türkiye Klinikleri yönetimine teşekkür ederim.

Prof. Dr. Rıfat EMRAL
Editör
Ankara Üniversitesi Tıp Fakülesi, Endokrinoloji ve Metabolizma Hastalıkları BD, Ankara, Türkiye
Hypoglycemia is defined as a condition in which the plasma glucose level drops below normal and this is felt by the person with the emergence of both autonomic and neuroglucopenic findings, and these findings disappear with the intake of foods containing glucose from outside. Although the plasma glucose threshold value in terms of hypoglycemia varies from person to person, it is well known that hypoglycemia is a serious stress condition for the organism and in some cases, if not treated promptly, it can cause serious morbidity and mortality.

Hypoglycemia, which usually occurs as a result of treatment in diabetic patients, can olası be an obstracle to the intensification of the treatment, can disrupt patients' compliance, and as a result, can become a factor that makes it difficult to improve glycemic regulation. This poses a significant risk fort he diabetic patients to be exposed to macro and microvascular complications due to hyperglycemia. Beyond this, diabetic individuals who experience frequent hypoglycemia become vulnerable to many other complications as well.

The causes of hypoglycemia observed in individuals who are not diabetic and therefore do not use anti-hyperglycemic agents constitute a wide range and hypoglycemia can often be one of the first signs of another underlying disease. Sometimes, substances used for different reasons or even medical treatment agents may be the cause of hypoglycemia. Therefore, recognizing hypoglycemia, identifying its cause, and treating it is often a challenging precess.

The aim of this book is to provide guidance to healthcare professionals and physicians regarding the ''Approach to Hypoglycemia'' and fort his purpose, the knowledge about ''Hypoglycemia'' was examined in detail by experts on the subject. I would like to thank all my colleagues who took part in the preparation of this book and management of the Türkiye Klinikleri.

Prof. Dr. Rıfat EMRAL
Editor
Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Türkiye

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