Hypoglycemia

Abstract

Summaryo1.In the study of the patient with hypoglycemia, consideration of the physiologic mechanisms which may produce low blood glucose levels is of help in the differential diagnosis of the cause of the hypoglycemia.2.Hypoglycemia is a symptom, not a disease, and the detection of low blood glucose levels is an urgent indication for investigation of the cause of the low blood glucose level.3.The organic hypoglycemias are characterized by prolonged, progressively severe hypoglycemic episodes of slow onset while fasting, with hypoglycemia unresponsiveness.4.The functional hypoglycemias are characterized by brief, nonprogressive hypoglycemia occuring after meals. Hypoglycemia responsiveness is normal.5.Painstaking use of oral and intravenous glucose tolerance tests, the intravenous insulin tolerance test and prolonged fasts aid in the differential diagnosis of hypoglycemia.6.New causes of hypoglycemia continue to be recognized. Careful study of these types of hypoglycemia has yielded information of physiologic, diagnostic and therapeutic importance. Some of these types of hypoglycemia have been described briefly. In the study of the patient with hypoglycemia, consideration of the physiologic mechanisms which may produce low blood glucose levels is of help in the differential diagnosis of the cause of the hypoglycemia. Hypoglycemia is a symptom, not a disease, and the detection of low blood glucose levels is an urgent indication for investigation of the cause of the low blood glucose level. The organic hypoglycemias are characterized by prolonged, progressively severe hypoglycemic episodes of slow onset while fasting, with hypoglycemia unresponsiveness. The functional hypoglycemias are characterized by brief, nonprogressive hypoglycemia occuring after meals. Hypoglycemia responsiveness is normal. Painstaking use of oral and intravenous glucose tolerance tests, the intravenous insulin tolerance test and prolonged fasts aid in the differential diagnosis of hypoglycemia. New causes of hypoglycemia continue to be recognized. Careful study of these types of hypoglycemia has yielded information of physiologic, diagnostic and therapeutic importance. Some of these types of hypoglycemia have been described briefly.