Classification of hypoglycemic disorders

The classification of symptoms of hypoglycemia, namely, reactive versus fasting, based on segregation by timing in relation to meals is no longer useful from a clinical point of view. Every patient with neuroglycopenic symptoms, regardless of relation to food ingestion, requires comprehensive evaluation. Identification of the possible cause of hypoglycemia and selection of diagnostic modalities are facilitated by considering whether the patient appears to be healthy (with or without compensated coexistent disease) or ill (with a disease known to have a proclivity to develop hypoglycemia, or is hospitalized). Medications may mediate hypoglycemia in anybody, whether they appear healthy or ill.