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Neurogenic hyperglycemia
Medical expert of the article
Last reviewed: 04.07.2025
Neurogenic hyperglycemia is manifested by an increase in blood sugar levels. It may be accompanied by hyperglycemic coma. Hyperglycemia is usually accompanied by glucosuria. Patients often complain of thirst. Polydipsia, polyuria, and skin itching are detected.
[ Causes neurogenic hyperglycemia
Neurogenic hyperglycemia, or "stress diabetes", can be caused by various factors leading to increased secretion of cortisol, glucagon, catecholamines, growth hormone, which contributes to the disruption of secretion and action of insulin. Acute changes in the regulatory hypothalamic-pituitary system are most often observed during periods of stress: hypothermia, general anesthesia, severe and extensive traumatic injuries, sepsis, extensive burns of the body, acute emotional stress. Can be observed with severe skull injuries, cerebral vascular thrombosis, encephalitis, heat strokes.
Pathogenesis
The pathological condition is based on a decrease in insulin levels, an increase in the concentration of glucagon, catecholamines, cortisol, ACTH, and growth hormone.
A decrease in insulin levels is usually the result of a previous increase in counter-insular hormones. The effect of increasing blood glucose levels should be called a multihormonal reaction. Hypothalamic control over carbohydrate metabolism is altered, which is mediated through vegetative (sympathetic activation) and neurohormonal links.
What tests are needed?
Differential diagnosis
Differential diagnosis should be made with diabetes mellitus, hormonal disorders with excessive secretion of counter-insular hormones in the context of Itsenko-Cushing syndrome and disease, acromegaly, pheochromocytoma. Hyperglycemia may also accompany a number of complex genetic syndromes, such as ataxia-telangiectasia, Lawrence-Moon-Bardet-Biedl syndrome, atrophic myotonia, Friedreich's ataxia, etc. One should not forget about the possibility of drug-induced hyperglycemia when using potassium-sparing diuretics, counter-insular hormones, psychotropic drugs.
Who to contact?
Treatment neurogenic hyperglycemia
An approach to eliminating neurogenic hyperglycemia by blocking peripheral alpha-adrenergic receptors is considered effective. For this purpose, alpha-adrenergic blockers are used - phentolamine 0.025 g 4 times a day or pyrroxane 0.015 g 4 times a day. Both drugs increase insulin secretion, thus normalizing blood sugar levels. However, specific therapeutic tactics are under development. It is possible to take various hypoglycemic agents.