<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0186-4866</journal-id>
<journal-title><![CDATA[Medicina interna de México]]></journal-title>
<abbrev-journal-title><![CDATA[Med. interna Méx.]]></abbrev-journal-title>
<issn>0186-4866</issn>
<publisher>
<publisher-name><![CDATA[Edición y Farmacia S.A. de C.V.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0186-48662018000600008</article-id>
<article-id pub-id-type="doi">10.24245/mim.v34i6.2040</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hipoglucemia: el tiempo es cerebro. ¿Qué estamos haciendo mal?]]></article-title>
<article-title xml:lang="en"><![CDATA[Hypoglycemia: Time is brain. What are we doing wrong?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Nares-Torices]]></surname>
<given-names><![CDATA[Miguel Ángel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Martínez]]></surname>
<given-names><![CDATA[Armando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Ayuso]]></surname>
<given-names><![CDATA[Francisco Agustín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morales-Fernández]]></surname>
<given-names><![CDATA[Manuel Orlando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,IMSS Centro Médico Nacional La Raza ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,IMSS Centro Médico Nacional La Raza ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>34</volume>
<numero>6</numero>
<fpage>881</fpage>
<lpage>895</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0186-48662018000600008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0186-48662018000600008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0186-48662018000600008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: Las complicaciones agudas de la diabetes representan aproximadamente 20 a 30% de los pacientes adultos hospitalizados en los servicios de urgencias. Cerca de 90% de todos los pacientes que reciben insulina experimentan al menos un episodio de hipoglucemia. Ante la disminución de concentraciones séricas de glucosa, tiene lugar una serie de respuestas en el organismo de manera escalonada. El primer mecanismo de defensa desencadenado es el cese de producción de insulina en las células B pancreáticas, apareciendo aproximadamente a 80 mg/dL. En segundo lugar, el aumento de la secreción de glucagón aparece alrededor de 68 mg/dL. El tejido cerebral consume aproximadamente 25% del consumo corporal total en su estado posabsortivo. La glucosa sérica atraviesa la barrera hematoencefálica a través de los capilares por difusión facilitada mediante el transportador GLUT-1. Las zonas más sensibles a la disminución de aporte glucémico son la corteza, el hipocampo y el cuerpo estriado. En este artículo se proporciona una visión de la fisiopatología en la hipoglucemia, con insistencia en sus efectos nocivos en el tejido cerebral, así como su abordaje dirigido a médicos en el servicio de urgencias.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Acute complications of diabetes account for approximately 20 to 30% of adult patients hospitalized in the emergency department. Approximately 90% of all patients recei-ving insulin experience at least one episode of hypoglycemia. As serum glucose levels decrease, a series of responses in the body occurs in a staggered fashion. The first triggered mechanism of defense is the cessation of insulin production in pancreatic B cells, appearing at approximately 80 mg/dL. Second, increased glucagon secretion appears around 68 mg/dL. Brain tissue consumes approximately 25% of total body consumption in its post-absorptive state. Serum glucose crosses the blood-brain barrier through the capillaries by diffusion facilitated by the GLUT-1 transporter. The most sensitive areas to decreased glycemic intake are the cortex, hippocampus and striatum. This article provides an overview of hypoglycemia pathophysiology, with emphasis on its deleterious effects on brain tissue, as well as its approach to physicians in the emergency department.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hipoglucemia]]></kwd>
<kwd lng="es"><![CDATA[muerte cerebral]]></kwd>
<kwd lng="es"><![CDATA[glucosa]]></kwd>
<kwd lng="es"><![CDATA[glucagón]]></kwd>
<kwd lng="en"><![CDATA[Hypoglycemia]]></kwd>
<kwd lng="en"><![CDATA[Brain death]]></kwd>
<kwd lng="en"><![CDATA[Glucose]]></kwd>
<kwd lng="en"><![CDATA[Glucagon]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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