Hypoglycemia - When to Refer
The diagnosis and treatment of hypoglycemia that is due to drugs, critical organ failure, or endocrine deficiency is usually straightforward. Referral of patients to an endocrinologist is warranted if they have documented fasting hypoglycemia and the diagnosis is not clear after a diagnostic fast with measurement of plasma insulin and C-peptide. Patients with endogenous hyperinsulinism should be referred to a surgeon with experience in treatment of these disorders.
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THE HYPOGLYCEMIC STATES
- Differential Diagnosis
- Hypoglycemia due to Pancreatic B cell tumors
L General Considerations
L Clinical Findings
- Persistent Islet Hyperplasia
- Hypoglycemia Due to Extrapancreatic Tumors
- Postprandial Hypoglycemia (Reactive Hypoglycemia)
L Postgastrectomy Alimentary Hypoglycemia
L Functional Alimentary Hypoglycemia
L Late Hypoglycemia (Occult Diabetes)
- Alcohol-Related Hypoglycemia
L Fasting Hypoglycemia after Ethanol
L Postethanol Reactive Hypoglycemia
- Factitious Hypoglycemia
- Immunopathologic Hypoglycemia
- Drug-Induced Hypoglycemia