RT Book, Section
A1 Cryer, Philip E.
A1 Davis, Stephen N.
A2 Jameson, J. Larry
SR Print(0)
ID 1141275881
T1 Hypoglycemia
T2 Harrison's Endocrinology, 4e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259835728
LK accessbiomedicalscience.mhmedical.com/content.aspx?aid=1141275881
RD 2024/04/19
AB Hypoglycemia  is  most  commonly  caused  by  drugs  used  to  treat  diabetes  mellitus  or  by  exposure  to  other  drugs,  including  alcohol.  However,  a  number  of  other  disorders,  including  critical  organ  failure,  sepsis  and  inanition,  hormone  deficiencies,  non-β-cell  tumors,  insulinoma,  and  prior  gastric  surgery,  can  cause  hypoglycemia  (Table  26-1).  Hypoglycemia  is  most  convincingly  documented  by  Whipple’s  triad:  (1)  symptoms  consistent  with  hypoglycemia,  (2)  a  low  plasma  glucose  concentration  measured  with  a  precise  method  (not  a  glucose  monitor),  and  (3)  relief  of  symptoms  after  the  plasma  glucose  level  is  raised.  The  lower  limit  of  the  fasting  plasma  glucose  concentration  is  normally  ∼70  mg/dL  (∼3.9  mmol/L),  but  lower  venous  glucose  levels  occur  normally,  late  after  a  meal,  during  pregnancy,  and  during  prolonged  fasting  (>24  h).  Hypoglycemia  can  cause  serious  morbidity;  if  severe  and  prolonged,  it  can  be  fatal.  It  should  be  considered  in  any  patient  with  episodes  of  confusion,  an  altered  level  of  consciousness,  or  a  seizure.