Abstract

VALE, Sofia Oliveira; MACHADO, Ana Catarina; MENESES, Adriana  and  ALVES, Sílvia Castro. Contribution to correlation between hyperglycemia and delirium. Rev Port Med Geral Fam [online]. 2019, vol.35, n.5, pp.424-427. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i5.12192.

Introduction: Delirium is one of the mental disorders observed in primary health care, particularly in the elderly. It may result of several subjacent medical conditions, namely metabolic unbalance with hyperglycemia, and a rapid etiologic diagnosis is critical. Description of the case: 80 years-old Caucasian woman, independent for daily life activities, four years of education, with a clinical history of obesity, hypertension, dyslipidemia, valvular disease and depression. She was brought to the family physician by her daughter due to intermittent polyphagia, impaired immediate and recent memory, incoherent speech, bradyphasia, attention deficit, sleep disturbance and irritability, since two months. She also had daily fluctuation of symptoms, with clinical deterioration in the three days prior to the consultation. She denied weight loss, polyuria or polydipsia. On physical examination she had a blood pressure of 136/57mmHg, stereotypical movements and a Mini-Mental State Examination (MMSE) score of 22/30. The study for secondary causes of cognitive decline established the diagnosis of type 2 diabetes mellitus (HbA1c: 14%) without other changes. She started a nutrition care plan, metformin and insulin. She was re-evaluated two and a half months later, referring to have followed the nutrition and exercise care plan rigorously, and improvement of the cognitive changes. Physical examination showed a blood pressure of 110/86mmHg, MMSE score: 25/30, normal test of the clock, and HbA1c of 7.8%. Comment: The recognition that hyperglycemia is one of the possible etiologies of delirium can accelerate the resolution of the symptoms and decrease its impact on patients' morbidity and mortality. The family physician should provide a close and continuous follow-up and to be aware that common pathologies may present with varied clinical presentations.

Keywords : Diabetes mellitus; Delirium; Hyperglycemia.

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