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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