Prolonged hypoglycemia leading to irreversible hypoglycemic encephalopathy: A case report

Abstract

Background: Hypoglycemia is a common metabolic emergency in diabetic patients; however, prolonged untreated hypoglycemia can result in irreversible neurological injury. We report the clinical course of a 59-year-old male with Type 2 Diabetes Mellitus who presented with delayed recognition of severe hypoglycemia leading to diffuse cerebral edema and hypoglycemic encephalopathy. Despite early correction of glucose and intensive neurocritical care management, the patient showed no meaningful neurological recovery. Serial neuroimaging demonstrated progression from metabolic brain injury to hypoxic-ischemic sequelae. This case highlights the importance of early recognition and prevention of prolonged hypoglycemia to avoid devastating neurological outcomes.