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Hypoglycemia, Nondiabetic

Description

  • 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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