In this article initial characteristics allowing knowledge of insulin resistance are described. High altitude dwellers show lower basal and postprandial glycemia and no differences in insulinemia compared with sea level dwellers. Incidence of diabetes mellitus is lower at high altitude. Finally studies in sea level residents under both acute natural hypoxia and simulated hypobaric chamber-intermittent hypoxia are presented.

Obesity is considered an epidemic disease. It is a risk factor for diabetes mellitus type 2 and some other metabolic and neoplastic disorders. The national and worldwide prevalence of obesity at high altitude and the relation between obesity and chronic and acute hypoxia at high altitude are revised.

Multiple endocrine neoplasia type 1 is a rare disease. It is characterized by the neuroendocrine, parathyroid, pituitary, and enteropancreatic tumor involvement. We present the case of a 19 year old patient with symptoms of headache, convulsions and weakness of the four extremities. The presence of hypoglycemia 33mg/dL was confirmed. The electromyographic study showed motor sensory polyneuropathy in all four extremities. The abdominal magnetic resonance showed a tumor in the tail of the pancreas that after the pancreatectomy was confirmed as insulinoma. The glycemia was normalized. In addition, he presented a pituitary macroadenoma, primary hyperparathyroidism and non-functioning adrenal tumor. At 25 years of age, he presented severe headache and amaurosis of the right eye. Axial tomography showed a giant pituitary tumor and in the study of pathology chondroid malignancy (chordoma) was d...

OBJETIVO: Determinar las características clínicas de los pacientes admitidos al Servicio de Emergencia con un cuadro de hipoglicemia. MATERIAL Y MÉTODOS:Estudio observacional, descriptivo de corte transversal de los pacientes que ingresaron al Servicio de Emergencia del Hospital Nacional Arzobispo Loayza de Lima con el diagnóstico de hipoglicemia, entre noviembre del 2003 a junio del 2004. RESULTADOS: De 64 pacientes, la edad media fue de 60,5 ± 37,5 años, siendo la mayoría de sexo femenino (71,9%). Un 62,5% de los pacientesera diabético (80% no insulinodependientes y 20% insulinodependientes). El hipoglicemiante oral asociado con mayor frecuencia a hipoglicemia fue la glibenclamida con un 84,4% seguido de la clorpropamida con un 6,3%; y, la insulina NPH, 50%. Las condiciones clínicas asociadas con mayor frecuencia a los estados de hipoglicemia fueron: insuficiencia renal cróni...

OBJETIVO: Determinar las características clínicas de los pacientes admitidos al Servicio de Emergencia con un cuadro de hipoglicemia. MATERIAL Y MÉTODOS:Estudio observacional, descriptivo de corte transversal de los pacientes que ingresaron al Servicio de Emergencia del Hospital Nacional Arzobispo Loayza de Lima con el diagnóstico de hipoglicemia, entre noviembre del 2003 a junio del 2004. RESULTADOS: De 64 pacientes, la edad media fue de 60,5 ± 37,5 años, siendo la mayoría de sexo femenino (71,9%). Un 62,5% de los pacientesera diabético (80% no insulinodependientes y 20% insulinodependientes). El hipoglicemiante oral asociado con mayor frecuencia a hipoglicemia fue la glibenclamida con un 84,4% seguido de la clorpropamida con un 6,3%; y, la insulina NPH, 50%. Las condiciones clínicas asociadas con mayor frecuencia a los estados de hipoglicemia fueron: insuficiencia renal cróni...

Dr. Emilio Pimentel Achilles Marticorena (1928-2007) was born 20 May 1928, in Villa de Arma in the province of Castrovirreyna, located 3700 m.s.n.m. His studies the school held at the Salesian College Huancayo and Alfonso College Ugarte in Lima. I study medicine at the National University San Marcos (San Marcos), obtaining Bachelor's degree in 1955 with the thesis entitled "Probable influence of great heights in determining the ductus arteriosus: Observations in 3000 school high "and subsequently received the title of Surgeon. He made graduate studies in the US. UU., cardiology at the University of Stanford (1961-1963), University Pennsylvania (1963 and 1964) and Center Presbyterian Medical in San Francisco, 1968; and later in the Institute Cardiology of the State of Sao Paulo, Brazil, in 1974.

El pie diabético (PD) es una complicación crónica de la DM, con etiología multifactorial, teniendo como factores principales la infección, isquemia, neuropatía y mal control metabólico. Tiene características clínicas frecuentes como úlceras, gangrenas y amputaciones en las extremidades inferiores, ocasionando en el paciente discapacidad parcial o definitiva.

El pie diabético (PD) es una complicación crónica de la DM, con etiología multifactorial, teniendo como factores principales la infección, isquemia, neuropatía y mal control metabólico. Tiene características clínicas frecuentes como úlceras, gangrenas y amputaciones en las extremidades inferiores, ocasionando en el paciente discapacidad parcial o definitiva.

The objective of this study was to determine the effect of hypoxia on iron stores comparing two groups of healthy and sedentary child-bearing women: one group was based in Lima at sea level (100-150 m) and the other included women living in Cerro de Pasco (4,338 m). The study subjects were women aged15 to 30 years old, with no risk factors for iron deficiency. They were randomly selected following these steps: 1. Filling a screening form; 2. Having a medical examination performed, also looking for risk factors that may modify serum ferritin levels; 3.Taking blood samples for measuring Hemoglobin (Hb), Hematocrit, and serum ferritin. Steps 1 and 2 allowed us to exclude women with excessive blood loss or those presenting with conditions that may modify iron metabolism. There were no significant differences with respect to age, but there were some differences in hematological parameters, su...

The objective of this study was to determine the effect of hypoxia on iron stores comparing two groups of healthy and sedentary child-bearing women: one group was based in Lima at sea level (100-150 m) and the other included women living in Cerro de Pasco (4,338 m). The study subjects were women aged15 to 30 years old, with no risk factors for iron deficiency. They were randomly selected following these steps: 1. Filling a screening form; 2. Having a medical examination performed, also looking for risk factors that may modify serum ferritin levels; 3.Taking blood samples for measuring Hemoglobin (Hb), Hematocrit, and serum ferritin. Steps 1 and 2 allowed us to exclude women with excessive blood loss or those presenting with conditions that may modify iron metabolism. There were no significant differences with respect to age, but there were some differences in hematological parameters, su...

The suggestive clinical characteristics of hyperandrogenism are very common problems in women and have been related with excessive androgen production from ovaries, suprarenal glands or both. The most common identifiable cause of androgen excess is the polycystic ovary syndrome. The virilizing tumors are rare. We report the case of a postmenopausal women with virilizing signs and a left anexial mass. Testosterone 4.3ng/mL (0.2-0.95); DHEAS 56ug/dL (35-430); androstenedione: 10ng/ml (0.4-2.7); Cortisol 16ug/dL. Testosterone post dexamethasone suppression test 3.5ng/mL. Ovarian steroid cell tumors secrete great quantities of testosterone or androstenedione and differ from Leydig cell tumors in that they lack crystals of Reinke. Usually, they are benign, but 20% of malignancy has been reported. They can produce different substances. The election treatment is oophorectomy. As in our p...