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.
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 sugar tests will help to
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)
Pictures
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins MD, FACP
- 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.
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