Recognition and differential diagnosis of spontaneous hypoglycaemia

Marks, Vincent

doi:10.1111/j.1365-2265.1992.tb02329.x

Cited by 31 publications

(14 citation statements)

References 67 publications

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“…In contrast to the above considerations, measurement of plasma insulin and proinsulin concentrations is necessary to establish the pathogenesis of fasting hypoglycemia (368 ). The diagnosis of an islet cell tumor is based on the persistence of inappropriately increased plasma insulin concentrations in the face of a low glucose concentration.…”

Section: B Frequency Of Measurementmentioning

confidence: 99%

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

et al. 2011

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BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence Based Laboratory Medicine Committee of the AACC jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (Hb A1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

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Section: B Frequency Of Measurementmentioning

confidence: 99%

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

et al. 2011

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“…This could, in part, explain why chronically hyperglycaemic patients may experience neuroglycopenia at higher glucose concentrations and chronically hypoglycaemic patients may experience it at lower glucose concentrations when compared with normal healthy subjects INVESTIGATION OF HYPOGLYCAEMIA [7][8][9][10][11] The investigation of hypoglycaemia involves an index of suspicion, confirmation, or exclusion of hypoglycaemia and its aetiology if it is confirmed. Spontaneous hypoglycaemia should be considered in anyone who presents with an episode or episodic subacute neuroglycopenia, even if there may be an alternative explanation for his or her symptoms.…”

Section: -9mentioning

confidence: 99%

Best Practice No 173: Clinical and laboratory investigation of adult spontaneous hypoglycaemia

Gama

2003

Journal of Clinical Pathology

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“…Non-islet cell tumour-associated hypoglycaemia is caused by the production of pro-IG.II, which acts on insulin receptors 3,5 . Tumour-derived IG.-II molecules represent truncated forms of pro-IG.-II with molecular weights ranging from 10-20kD, instead of the fully processed 7.4 kD peptide 8 .…”

Section: Discussionmentioning

confidence: 99%

Hypoglycaemia secondary to the secretion of pro-insulin like growth factor ii by a metastatic neuroendocrine tumour with sarcomatous differentiation

Morgan

Nanzer²,

Camacho‐Hübner³

et al. 2003

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A patient presented with frequent episodes of spontaneous hypoglycaemia due to a disseminated neuroendocrine tumour with sarcomatous differentiation, secreting incompletely processed proinsulin-like growth factor II (pro-IG.-II). Although the combination of GH and glucocorticoid therapy initially controlled the hypoglycaemia, there was a later escape necessitating frequent readmissions to hospital. The patient deceased two weeks following her latest admission.

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Recognition and differential diagnosis of spontaneous hypoglycaemia

Cited by 31 publications

References 67 publications

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Best Practice No 173: Clinical and laboratory investigation of adult spontaneous hypoglycaemia

Hypoglycaemia secondary to the secretion of pro-insulin like growth factor ii by a metastatic neuroendocrine tumour with sarcomatous differentiation

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