Brief report Recurrent bilateral dislocation of the shoulders due to nocturnal hypoglycemia: A case report Abdurrahman O ¨ zc ¸elik a, * , Murat Dinc ¸er b , Haldun C ¸ etinkanat a a Department of Orthopaedics, Osmangazi University Hospital, Mes ¸elik 26480, Eskis ¸ehir, Turkey b Department of Internal Medicine, Osmangazi University Hospital, Eskis ¸ehir, Turkey Received 13 July 2005; accepted 15 July 2005 Available online 24 August 2005 Abstract A 20-year-old male was admitted to emergency room with convulsion. He had insulin-dependent diabetes mellitus for 8 years. He had suffered nocturnal hypoglycemia after strenuous exercise without additional calories. After recovery, the patient complained of bilateral anterior shoulder dislocation. Patient’s history revealed another episode of bilateral shoulder dislocations after an hypoglycemic convulsion 3 years ago. # 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: Hypoglycemia; Bilateral dislocation; Convulsion; Insulin therapy Hypoglycemia is a common side effect of insulin therapy and is associated with significant mortality and morbidity rates in diabetic patients [1]; whereas, musculoskeletal injuries related to hypoglycemic convulsions were seldom reported, which were included long bone and vertebral fractures and major joint dislocations [1–4]. There are only four pre- viously reported cases of the shoulder joint dislocation [1,2,4], one of which occurred bilateral anterior dislocation [2]. We first report a case with hypogly- cemic convulsions associated with recurrent simulta- neous bilateral dislocation of the shoulders. 1. Case report A 20-year-old male was admitted to emergency room with convulsion. He had insulin-dependent diabetes mellitus for 8 years. He required 1.2 U/kg OI insulin twice daily OI soluble and lente insulins. He had suffered nocturnal hypoglycemia after strenuous exercise without additional calories. After recovery, the patient complained of bilateral shoulder pain and CT scan showed bilateral anterior dislocations of the shoulders and the fracture of the left tuberculum majus (Fig. 1). Patient’s history revealed another episode of bilateral shoulder dislocations after an hypoglycemic convulsion 3 years ago. After closed reduction under general anesthesia and 6 weeks of immobilization, full unrestricted motion was www.elsevier.com/locate/diabres Diabetes Research and Clinical Practice 71 (2006) 353–355 * Corresponding author. Tel.: +90 542 6249850; fax: +90 222 2309632. E-mail address: aozcelik@ogu.edu.tr (A. O ¨ zc ¸elik). 0168-8227/$ – see front matter # 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.diabres.2005.07.006