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Hypoglycemia and its Causes

A working definition of clinical hypoglycaemia is a low blood glucose level less than 3.0 mmol/l, associated with characteristic, but non-specific, symptoms which are reversed by the administration of glucose.

Causes

1. Exogenous causes
  •     IV or Subcutaneous Insulin therapy
  •     Oral hypoglycaemics (overdose)
  •      Ethanol (inhibit gluconeogenesis)
  •      Drugs: salicylates, beta-adrenergic blockers

Glucose meter

Image courtesy of CDC/ Amanda Mills

2. Endogenous causes

Reactive

  •         Idiopathic (functional)
  •         Early diabetes mellitus (adult onset)
  •         Autoimmune hypoglycaemia

Fasting

  •         Insulinoma
  •         Non-pancreatic neoplasms
  •         Adrenocortical deficiency
  •         Hypopituitarism (growth hormone deficiency)
  •         Liver failure (impaired gluconeogenesis or gluconeogenesis storage)
  •         Renal failure (loss of glucose in urine)
  •         Sepsis
  •         Autoimmune hypoglycaemia

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