Abstract
Insulin abuse resulting in hypoglycemia was originally reported in 1947.1,2 However, not until the 1970s was the serum C-peptide level recognized to be a reliable marker of pancreatic β-cell activity.3 Human C-peptide radioimmunoassay has been advocated recently as a useful test in diagnosing insulin-induced factitious hypoglycemia.4,5 This report describes a case of child abuse presenting as hypoglycemic coma secondary to insulin injection. The diagnosis was made by the presence of the pathognomonic triad: hypoglycemia, hyperinsulinemia, and low serum levels of C-peptide. CASE REPORT A 2-year-old black boy was brought to the emergency room in an unresponsive state. He was said to be unarousable after his regular afternoon nap.
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