- Hypoglycemia defined by Whipple triad:
- Low plasma glucose level (≤60 mg/dL)
- Hypoglycemic symptoms that are relieved when glucose level is corrected
- Occurs commonly in patients with diabetes receiving sulfonylurea or insulins; less commonly in patients without diabetes
- Reactive hypoglycemia:
- Occurs in response to a meal, drugs, herbal substances, or nutrients
- May occur 2–3 hours postprandially or later
- Symptoms generally observed with serum glucose ≤60 mg/dL, lower in patients with hypoglycemic unawareness
- Also seen after GI surgery (in association with dumping syndrome in some patients)
- Spontaneous (fasting) hypoglycemia:
- May be associated with a primary condition, including hypopituitarism, Addison disease, myxedema, or in disorders related to hepatic dysfunction or renal failure
- If hypoglycemia presents as a primary disorder, consider hyperinsulinism and extrapancreatic tumors.
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