Factitious hypoglycemia due to chlorpropamide. Report of a case, with clinical similarity to an islet cell tumor of the pancreas.

Abstract

FACTITIOUS HYPOGLYCEMIA, or hypoglycemia due to surreptitious self-administration of insulin, is an uncommon but recognized entity. 1,2 Conn and Seltzer 3 reported 1 case and Rynearson 4 reported 3 such cases, in one of which 7 exploratory operations and an eventual total pancreatectomy were performed in attempts to remove a suspected functioning islet cell tumor of the pancreas. It has been suggested that factitious hypoglycemia be suspected in patients who are diabetic, in the family of the diabetic, or in medical personnel such as physicians or nurses to whom knowledge of hypoglycemic agents and their actions is readily accessible. Oral hypoglycemic agents employed in the treatment of diabetes vary in their hypoglycemia-producing properties. Tolbutamide (Orinase) rarely provokes hypoglycemia, whereas unless guarded against, chlorpropamide (Diabinese) is not an infrequent cause of abnormally low concentrations of sugar in the blood. No reported case of factitious use of chlorpropamide in producing clinical