Mr. Vinh, a patient with type 2 diabetes for over 18 years, had been regularly taking insulin and medication. For over a month, with stable blood sugar levels, he believed his condition had improved, leading him to stop his medication. He also adopted a strict diet, largely eliminating white rice and consuming only small amounts of brown rice and vegetables.

Despite Mr. Vinh's symptoms mimicking a stroke, an MRI scan revealed no brain damage. Concurrently, his blood sugar level plummeted to just 45 mg/dL, significantly below the normal fasting range of over 80 mg/dL.

Doctors at Tam Anh General Hospital TP HCM diagnosed Mr. Vinh with severe hypoglycemia, leading to a pseudo-stroke. Hypoglycemia symptoms, such as seizures, coma, and limb paralysis, closely resemble those of a brain stroke. Following emergency fluid and glucose infusions to stabilize his blood sugar, Mr. Vinh received treatment in the Endocrinology - Diabetes Department.

Doctor Hoang examines Mr. Vinh. Photo: Tam Anh General Hospital

Doctor Lam Van Hoang, head of the Endocrinology - Diabetes Department at Tam Anh General Hospital TP HCM, outlined the target blood sugar levels for diabetic patients: pre-meal blood sugar between 4,4-7,2 mmol/L, post-meal (1-2h) below 10,0 mmol/L, no hypoglycemia, and an HbA1C level below 7,0%. He emphasized that excessive dieting significantly increases the risk of hypoglycemia in individuals with diabetes.

"Mr. Vinh is elderly and has long-term diabetes, but his drastic reduction in carbohydrates led to an energy deficit, making him prone to hypoglycemia," doctor Hoang explained. He added that discontinuing insulin and other blood sugar-lowering medications without medical supervision causes blood sugar levels to become uncontrolled, potentially leading to extreme fluctuations.

Alongside his medical treatment, Mr. Vinh received counseling on a scientific and healthy diet. This included advice to consume sufficient essential nutrient groups, avoid excessive dietary restrictions, and eat regular, timely meals. He was also instructed to take his medication and administer insulin at the correct dosage and time, precisely as prescribed by his doctor.

Doctor Hoang warned that severe hypoglycemia in diabetic patients, if not managed promptly, can lead to brain damage, acute myocardial infarction, and even death. He stressed that patients must never unilaterally reduce or discontinue their medication, even if their blood sugar levels appear stable. Regular follow-up appointments are crucial for doctors to adjust treatment protocols as needed.

Bach Duong

*Patient's name has been changed