Nursing Care of One Patient with Recurrent Hypoglycemia Complicated by Upper Gastrointestinal Bleeding and Mitochondrial Encephalomyopathy
Year: 2026
Type: article
Study design: Case Report
Abstract: Patients with upper gastrointestinal bleeding (UGIB) face elevated risks of hypoglycemia during fasting periods. If concurrent mitochondrial encephalomyopathy (ME) is present, impaired energy metabolism drastically amplifies such risks. This paper reports a clinical case of a 42-year-old male patient with a 5-year history of ME, admitted for bleeding caused by duodenal bulbar ulcer requiring absolute fasting. Conventional intravenous glucose supplementation failed to stop recurrent refractory hypoglycemia. Based on the pathological mechanism of impaired gluconeogenesis and defective energy utilization resulting from mitochondrial dysfunction in ME patients, the medical team developed three innovative core nursing interventions:(1) Advance the hypoglycemia warning threshold: raise the critical blood glucose cutoff from 3.9 mmol/L to 5.6 mmol/L and implement predictive intervention;(2) Maintain continuous intravenous fluid infusion to supply stable exogenous energy substrates;(3) Administer sequential short-peptide enteral nutrition to build multiple energy supply pathways. This combined protocol successfully stabilized the patient's blood glucose levels, without severe complications, and the patient was discharged smoothly. The intervention strategy breaks through the limitations of single intravenous glucose supplementation and embodies individualized nursing guided by pathophysiological mechanisms. This clinical case provides new insights into blood glucose management for acutely fasting patients complicated with rare metabolic disorders. It reminds clinical nurses to stay alert to special underlying causes of non-diabetic hypoglycemia and advocates comprehensive intervention under multidisciplinary collaboration.
Source: MEDS Clinical Medicine
Author: Linlin Chen
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7212455515