Hypothermia as a forgotten sign of prolonged severe hypoglycaemia

Hypothermia is often a sign of serious illness. Commonly reported aetiologies include but are not limited to sepsis, exposure to cold and endocrine disorders. Hypoglycaemia, a common occurrence, is rarely associated with hypothermia. We present a case of prolonged, severe hypothermia due to hypoglycaemia. A 58-year-old man with diabetes who presented with chest pain and was diagnosed with Non-ST elevation myocardial infarction. He was given nothing per mouth in preparation for a left heart catheterisation but received his reported insulin glargine dosage at bedtime. A few hours later, he was noted to have diaphoresis and hypoglycaemia, and his temperature steadily started dropping which was unresponsive to local warming. Once his hypoglycaemia was successfully treated with dextrose infusion, his temperature improved. An extensive workup revealed no infective or endocrine disorder.