Sulfonylurea-induced factitious hypoglycemia in a nondiabetic nurse

A case of sulfonylureainduced factitious hypoglycemia occurring in a nondiabetic medical nurse is reported. The patient presented with symptoms of hypoglycemia, consistently low fasting plasma glucose values and a reversal of symptoms with glucose administration. An intravenous tolbutamide provocative test on two occasions showed little increase in plasma glucose values. The case is presented to illustrate that sulfonylureainduced hypoglycemia should be considered in the differential diagnosis of fasting adult hypoglycemia, especially in paramedical personnel, and particularly in those with a poor response to the intravenous tolbutamide test.