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How should we differentiate hypoglycaemia in non-diabetic patients?
Michele R Modestino1, Olimpia Iacono1, Laura Ferrentino1
1Department of Translational Medical Sciences, 165474 Federico II University Hospital , Napoli, Italy.
Journal of Basic and Clinical Physiology and Pharmacology
|April 15, 2024
Summary
Diagnosing hypoglycaemia (low blood glucose) in healthy individuals is challenging due to nonspecific symptoms. This review outlines diagnostic approaches, including the Whipple Triad and specific lab tests, to identify various causes.
Area of Science:
- Endocrinology
- Clinical Medicine
- Diagnostic Challenges
Background:
- Hypoglycaemia (low blood glucose) in healthy individuals presents diagnostic difficulties for clinicians.
- Nonspecific symptoms necessitate a structured diagnostic approach.
Purpose of the Study:
- To review current guidelines and strategies for diagnosing hypoglycaemic syndromes in apparently healthy individuals.
- To outline diagnostic tests and differentiate the aetiologies of hypoglycaemia.
Main Methods:
- Documentation of the Whipple Triad (symptoms, symptom relief with glucose, low plasma glucose) is crucial.
- Meticulous patient history and laboratory tests (glucose, insulin, proinsulin, C-peptide, β-hydroxybutyrate, anti-insulin antibodies) are essential.
- Further specific tests are guided by initial results.
Main Results:
- The Whipple Triad serves as a critical initial diagnostic criterion.
- Comprehensive laboratory testing aids in identifying the underlying cause of hypoglycaemia.
- Rare conditions like nesidioblastosis and Hirata's syndrome are considered.
Conclusions:
- A systematic approach, starting with the Whipple Triad and supported by targeted laboratory investigations, is key to diagnosing hypoglycaemia.
- This review provides a framework for differentiating various hypoglycaemia aetiologies, including rare disorders.
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