Failure of Normal Glycaemic Regulation in a Patient With Severe Hypothermia

This report describes the case of an 88-year-old non-diabetic female who presented to the emergency department severely hypothermic following a presumed hypoglycaemic collapse due to self-neglect. Subsequent rewarming and resuscitation demonstrated a number of the significant consequences of severe hypothermia, including apparent secondary impairment of glycaemic autoregulation. The phenomenon of reversible inhibition of insulin secretion due to severe hypothermia has previously been documented in the field of cardiac surgery. The hyperglycaemia was not treated with any antihyperglycaemic agent, and her recovery was uneventful. Subsequent blood sugar level monitoring was normal. If administering insulin to the hypothermic patient, intensive monitoring of blood glucose is essential due to the increase in endogenous insulin secretion on rewarming