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Recognizing factitious hypoglycemia in the family practice setting.
J Am Board Fam Pract. 1999 Mar-Apr; 12(2):133-6.JA

Abstract

BACKGROUND

Factitious hypoglycemia is a deliberate attempt to induce a low serum glucose level using either insulin or oral hypoglycemic agents. Sulfonylurea-induced hypoglycemia is more common than incidents of insulin abuse, and hypoglycemia caused by these oral agents is biochemically indistinguishable from insulinoma.

METHODS

We describe a case of factitious hypoglycemia resulting from insulin abuse in an adult diabetic patient, review the essentials of glucose homeostasis, and describe diagnostic tests that allow a differential diagnosis.

RESULTS AND CONCLUSION

Factitious hypoglycemia is associated with a higher incidence of suicide, depression, and personality disorders. Insulin-induced hypoglycemia can be detected by an insulin to C-peptide ratio that is greater than 1.0. In the absence of proof to the contrary, insulinoma should be considered the cause of hypoglycemia until another diagnosis is established. The generally poor prognosis for patients with factitious hypoglycemia underscores the importance of early recognition of factitious disorders.

Authors+Show Affiliations

Department of Family Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

10220236

Citation

Waickus, C M., et al. "Recognizing Factitious Hypoglycemia in the Family Practice Setting." The Journal of the American Board of Family Practice, vol. 12, no. 2, 1999, pp. 133-6.
Waickus CM, de Bustros A, Shakil A. Recognizing factitious hypoglycemia in the family practice setting. J Am Board Fam Pract. 1999;12(2):133-6.
Waickus, C. M., de Bustros, A., & Shakil, A. (1999). Recognizing factitious hypoglycemia in the family practice setting. The Journal of the American Board of Family Practice, 12(2), 133-6.
Waickus CM, de Bustros A, Shakil A. Recognizing Factitious Hypoglycemia in the Family Practice Setting. J Am Board Fam Pract. 1999 Mar-Apr;12(2):133-6. PubMed PMID: 10220236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recognizing factitious hypoglycemia in the family practice setting. AU - Waickus,C M, AU - de Bustros,A, AU - Shakil,A, PY - 1999/4/29/pubmed PY - 1999/4/29/medline PY - 1999/4/29/entrez SP - 133 EP - 6 JF - The Journal of the American Board of Family Practice JO - J Am Board Fam Pract VL - 12 IS - 2 N2 - BACKGROUND: Factitious hypoglycemia is a deliberate attempt to induce a low serum glucose level using either insulin or oral hypoglycemic agents. Sulfonylurea-induced hypoglycemia is more common than incidents of insulin abuse, and hypoglycemia caused by these oral agents is biochemically indistinguishable from insulinoma. METHODS: We describe a case of factitious hypoglycemia resulting from insulin abuse in an adult diabetic patient, review the essentials of glucose homeostasis, and describe diagnostic tests that allow a differential diagnosis. RESULTS AND CONCLUSION: Factitious hypoglycemia is associated with a higher incidence of suicide, depression, and personality disorders. Insulin-induced hypoglycemia can be detected by an insulin to C-peptide ratio that is greater than 1.0. In the absence of proof to the contrary, insulinoma should be considered the cause of hypoglycemia until another diagnosis is established. The generally poor prognosis for patients with factitious hypoglycemia underscores the importance of early recognition of factitious disorders. SN - 0893-8652 UR - https://www.unboundmedicine.com/medline/citation/10220236/Recognizing_factitious_hypoglycemia_in_the_family_practice_setting_ DB - PRIME DP - Unbound Medicine ER -