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Harrison's Principles of Internal Medicine, 18e
| Part 16. Endocrinology and Metabolism > Section 1. Endocrinology > |
Chapter 345. Hypoglycemia
Sections: Hypoglycemia: Introduction, Systemic Glucose Balance and Glucose Counterregulation, Further Readings.
Topics Discussed: hypoglycemia.
Excerpt:"Hypoglycemia is most commonly caused by drugs used to treat diabetes mellitus or by exposure to other drugs, including alcohol. However, a number of other disorders, including critical organ failure, sepsis and inanition, hormone deficiencies, non–beta-cell tumors, insulinoma, and prior gastric surgery, may cause hypoglycemia (Table 345-1). Hypoglycemia is most convincingly documented by Whipple's triad: (1) symptoms consistent with hypoglycemia, (2) a low plasma glucose concentration measured with a precise method (not a glucose monitor), and (3) relief of those symptoms after the plasma glucose level is raised. The lower limit of the fasting plasma glucose concentration is normally approximately 70 mg/dL (3.9 mmol/L), but substantially lower venous glucose levels occur normally, late after a meal. Glucose levels <55 mg/dL (3.0 mmol/L) with symptoms that are relieved promptly after the glucose level is raised document hypoglycemia. Hypoglycemia can cause serious morbidity; if severe and prolonged, it can be fatal. It should be considered in any patient with episodes of confusion, an altered level of consciousness, or a seizure...."
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