Hypoglycemia is a syndrome with a wide variety of causes. In this condition, low blood glucose concentrations lead to a constellation of signs and symptoms that I will be discussing in this article. This article will also enumerate the laboratory evaluation of patients with hypoglycemia. This article may be more relevant to patients who have diabetes and are on exogenous insulin or oral diabetic medications.
Instructions
1. CAUSES:
Drugs:
* Insulin therapy
* Oral diabetes medications (sulfonylurea)
* Anti-hypertensive medication (lisinopril)
* Aspirin
* Quinine
* Haloperidol (Haldol)
Alcohol
Insulinoma (small tumor in pancreas secreting abnormally high insulin)
Factitious hypoglycemia (by injecting insulin a diabetic drug)
Intense exercise
2. SYMPTOMS:
Sweating
Sensation of warmth
Anxiety
Tremor or tremulousness
Nausea
Palpitations
Increased heart rate
Hunger
Fatigue
Dizziness
Headache
Visual disturbances
Drowsiness
Difficulty speaking
Inability to concentrate
Abnormal behavior
Loss of memory
Confusion
Seizures
Ultimately, loss of consciousness or coma
3. Labs:
Blood glucose levels is the gold standard test to diagnose hypoglycemia (generally blood glucose level below 60mg/dl is considered to be hypoglycemia). Blood glucometers that are available in the market for self testing may not be accurate, however.
4. To diagnose insulinoma (pancreatic insulin secreting tumor) more extensive testing may be required. This includes measuring following levels after as 72 hour supervised fast:
Plasma glucose
Insulin
C-peptide
Pro insulin
Beta-hydroxy butyrate
Sulfonylurea
High resolution CT of abdomen, MRI or PET scan may also be dome to locate the tumor.
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