Pseudohypoglycemia in adult victims of adolescent incest

Two patients with complaints of hypoglycemia came for evaluation, and both complained of intermittent episodes of mental dullness, disorientation, confusion, and palpitations relieved by eating. Plasma glucose levels at the time of symptoms were always above 70 mg/dL. Initial onset of symptoms was within 1 to 2 years after cessation of repeated incest, and on recognition of this, both patients associated the onset of episodes of similar feelings with the acts of incest. Recognition of this connection did not decrease the frequency of episodes. Both persistently refer to the episodes as "hypoglycemia" despite recognition that no glucose level below 70 mg/dL has been recorded during an episode. Recurrent episodes of derealization and depersonalization in both patients appear to be sequelae of adolescent incest experiences, but these patients cling to the label "hypoglycemia," perhaps in part because they are unwilling to accept a psychiatric diagnosis for their episodes.