Hypoglycemia and its relationship with stroke in an elderly adult with multiple comorbidities, especially type 2 diabetes mellitus

Díaz-Gerevini-GT*, Parisi C, Reartes G, Rojas P, Wilson V, Priotto Santiago, Repossi G

Received : January 26, 2026 | Published : February 27, 2026

Citation: Díaz-Gerevini-GT, Parisi C, Reartes G, Rojas P, Wilson V, Priotto S, Repossi G. Hypoglycemia and its relationship with stroke in an elderly adult with multiple comorbidities, especially type 2 diabetes mellitus. J Case Rep Rev Med. 2026;2(1):1-3.

Abstract

Introduction: Hypoglycemia is an episode of abnormally low plasma glucose concentration (70 mg/ml or less) that exposes the individual to serious harm. In this state, the adrenocortical system increases the release of catecholamines as a compensatory mechanism. In some cases, this leads to an excessive increase in blood pressure, triggers arrhythmias, and activates the coagulation system, generating emboli that can cause a stroke. This abnormal response is exacerbated by the decline in autonomic responses in old age, which can increase the susceptibility of older adults (OA) with type 2 diabetes (T2D) to severe hypoglycemia, especially if they also have other comorbidities such as obesity, hypertension, and hypothyroidism, which contribute to frailty.

Case report: A 74-year-old woman was seen in the emergency department for loss of consciousness and pain. Her blood glucose level was 50 mg/dL, and she presented with cardiac arrhythmia and hypertension. She had a history of central obesity, T2D, hypertension, and hypothyroidism, and was medicated with metformin, vildagliptin, glimepiride, valsartan, and levothyroxine. She was seen in the emergency department, where she was diagnosed, hydrated, and given glucose. She was then admitted to the ICU. An initial CT scan showed no signifi cant changes. After 48 hours, signs of a stroke were present, and after one month, the lesions were stable. Metabolic and cardiovascular parameters stabilized, rehabilitation began, and the patient regained independence within a month.

Conclusion: Understanding the patient, timely intervention, causal reversal, and rehabilitation are vital in the management of hypoglycemia complicated by stroke.