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Transient loss of consciousness, syncope and hypoglycaemia

Lagi, Alfonso; Cencetti, Simone

Cardiovascular Endocrinology: June 2012 - Volume 1 - Issue 2 - p 20–23
doi: 10.1097/XCE.0b013e32835744c0
Original article

Background Very few reports focus on the relationship between hypoglicaemia and transient loss of consciousness.

Objectives The aim of this work is to determine whether diabetic patients with transient loss of consciousness have blood glycaemia lower than that of individuals in the control group, and to identify the clinical elements that characterize the kind of transient loss of consciousness.

Methods Consecutive patients with diabetes and observed for transient loss of consciousness were studied. The inclusion criteria were as follows: that at the syncope a reliable witness was present and determination of glycaemia at arrival to hospital without pharmacological or food interference. The length of syncope, muscle tone, postcritical mental status and autonomic symptoms were assessed using a dedicated protocol.

Results The study included 40 patients. They had characteristics that were different from those of the controls: they had lower glycaemia at hospital recovery (4.4 vs. 6.2 mmol/l), longer transient loss of consciousness (19 vs. 6 min), lower occurrence of muscle tone loss (8 vs. 25 patients) and higher occurrence of mental impairment after the episode (26 vs. 13 patients). The associated autonomic symptoms were not significant (20 vs. 27 patients).

Conclusion There was an association between episodes of transient loss of consciousness and low levels of glycaemia in diabetic patients on treatment. They had specific characteristics: they maintained muscle tone and showed postcritical mental impairment. These findings have diagnostic and therapeutic implications.

Syncope Unit, Emergency Department, Ospedale Santa Maria Nuova, Florence, Italy

Correspondence to Alfonso Lagi, MD, Syncope Unit, Emergency Department, Ospedale Santa Maria Nuova, Via G. Mameli 44-50131, Florence, Italy Tel: +39 055 583182; fax: +39 055 2758386; e-mail:

Received June 5, 2012

Accepted June 21, 2012

© 2012Wolters Kluwer Health Lippincott Williams Wilkins