Hypoglycemia diagnostic criteria: Difference between revisions
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|[[Autoimmune]] hypoglycemia | |[[Autoimmune]] hypoglycemia | ||
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=== Neonatal hypoglycemia: === | === Neonatal hypoglycemia: === | ||
* Measure [[Insulin|plasma insulin]], plasma [[C-peptide]] and [[beta-hydroxybutyrate]] | |||
* | * [[PH|Blood pH,]] [[bicarbonate]], and [[lactate]] | ||
* [[ | * [[Free fatty acids]], [[Acylcarnitine hydrolase|acylcarnitine profile]], plasma free and total [[Carnitine|carnitine levels]] | ||
* [[ | |||
* | * [[Growth hormone]] and [[cortisol]] | ||
* [[Urine organic acids]] and [[Amino acids|serum amino acids]] | |||
==References== | ==References== | ||
<references /> |
Revision as of 13:40, 22 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
The following 3 characteristics should be present to diagnose hypoglycemia, which is called Whipple's triad and includes:
- Symptoms of hypoglycemia
- A low plasma glucose concentration correlated with symptoms
- Correction of glucose level relieves symptoms
The strategy is to seek Whipple's triad under conditions in which hypoglycemia would be expected:
- If the symptoms occur in the fasting state, that evaluation should be performed during fasting.
- If there is a compelling history of postprandial symptoms, it is reasonable to seek Whipple's triad with frequent, timed plasma glucose measurements and recording of any symptoms after a mixed meal.
Identifying the cause
After confirmation of hypoglycemia. Physicians should have history, signs and laboratory results sufficient to help them to identify the cause of hypoglycemia:
Plasma insulin | C-peptide | proinsulin | Sulfonylurea in plasma | insulin or insulin receptor antibodies | Postprandial symptoms | Fating symptoms | |
---|---|---|---|---|---|---|---|
Insulinoma | high | high | high | - | - | - | + |
Oral hypoglycemics | high | high | high | + | - | - | - |
Autoimmune hypoglycemia | high | high | high | - | + | - | - |
NIPHS* | high | high | high | - | - | + | - |
Exogenous insulin | high | low | low | - | - | - | - |
Non-islet cell tumors | low | low | low | - | - | - | - |
*(NIPHS) non-insulinoma pancreatogenous hypoglycemia syndrome
Neonatal hypoglycemia:
- Measure plasma insulin, plasma C-peptide and beta-hydroxybutyrate
- Blood pH, bicarbonate, and lactate
- Free fatty acids, acylcarnitine profile, plasma free and total carnitine levels