PMID: 9429866Jan 16, 1998Paper

Hypoglycemia

Endocrinology and Metabolism Clinics of North America
F J Service

Abstract

The diagnosis of a hypoglycemic disorder requires a high level of suspicion, careful assessment of the patient for the presence of mediating drugs or predisposing illness, and, when indicated, methodic evaluation of the basis of well-defined diagnostic criteria. The diagnostic burden is heaviest for healthy-appearing persons with episodes of confirmed neuroglycopenia. The author's criteria for insulin mediation of hypoglycemia are plasma insulin of 6 microU/mL or higher (radioimmunoassay), C-peptide of 200 pmol/L or higher (ICMA), proinsulin of 5 pmol/L or higher (ICMA), beta OH butyrate of 2.7 mmol/L or lower, and generous (> or = 25 mg/dL) response of plasma glucose to intravenous glucagon administered when the patient is hypoglycemic. Sulfonylurea should be sought in the plasma of any hypoglycemic patient, especially by an assay which can detect the second generation of these drugs.

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Citations

Dec 12, 2007·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Christopher R DeWittJavier C Waksman
Jan 7, 2014·Current Treatment Options in Neurology·Janice J Hwang, David Y Hwang
Oct 17, 1998·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·E M Gibson, M S Tingen
Sep 29, 1999·Endocrinology and Metabolism Clinics of North America·P E Cryer
Jan 10, 2001·Endocrinology and Metabolism Clinics of North America·G Herbel, P J Boyle
Jun 17, 2000·Trends in Endocrinology and Metabolism : TEM·D J Becker, C M Ryan
Dec 1, 2001·Journal of Midwifery & Women's Health·N C Haninger, C L Farley
Aug 18, 2010·BMC Health Services Research·Jane B LemaireDelia Roberts
Jun 15, 2017·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Diane DoneganAdrian Vella
Apr 21, 2009·Annales Françaises D'anesthèsie Et De Rèanimation·G SeematterL Tappy

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