HYPOGLYCEMIA
HYPOGLYCEMIA: Excerpt from Differential Diagnosis in Primary Care
A list of possibilities for hypoglycemia may be had simply by thinking of the endocrine glands. Consequently, thinking of the pancreas one could recall an insulinoma. Thinking of the adrenal gland, one would recall Addison disease. Considering the pituitary one would remember hypopituitarism and the thyroid—hypothyroidism. Unfortunately, a few conditions may be overlooked by this method alone. If none of the above diagnoses seem to fit, the patient may have glycogen storage disease, cirrhosis, or functional hypoglycemia. Diabetics with hypoglycemia may be taking too much insulin or their doses of oral hypoglycemic agents may be too high.
HYPOGLYCEMIA
Approach to the Diagnosis
The clinical picture may fit one of the endocrine disorders mentioned above. If not, the laboratory can be of tremendous assistance. A glucose tolerance test will help diagnose functional hypoglycemia. Hospitalization for a 72-hour fast while taking frequent blood sugars will help diagnose an insulinoma.
Other Useful Tests
- CBC
- Urinalysis
- Chemistry panel (advanced liver disease)
- Liver profile (cirrhosis)
- Thyroid profile (hypothyroidism, hypopituitarism)
- Plasma cortisol level (Addison disease)
- Serum growth hormone assay (hypopituitarism)
- C-peptide level (insulinoma)
- Plasma insulin assay (insulinoma)
- Tolbutamide tolerance test (insulinoma)
- Endocrine consult
- CT scan of the abdomen (insulinoma, glycogen storage disease)
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins
- Year of Publication: 2007
- Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
» Next page: Hypoglycemia (A Pocket Manual of Differential Diagnosis)
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