Hyperinsulinemic hypoglycemia in adults - 12/10/17
Resumen |
The diagnosis of a hypoglycemic disorder requires a high level of suspicion, careful assessment of the patient for the presence of mediating drugs or a predisposing illness, and, where indicated, methodical evaluation on the basis of well-defined diagnostic criteria.
The diagnostic burden is heaviest for healthy-appearing persons with episodes of confirmed neuroglycopenia. Our criteria for insulin mediation of hypoglycemia are: plasma insulin ≥18 pmol (ICMA immunochemiluminometric assay.), C-peptide ≥200pmol/L (ICMA), proinsulin ≥5pmol/L (ICMA), ≥OH butyrate, ≤2.7mmol/L and generous (1.4mmol/L) response of plasma glucose to IV glucagon administered when the patient is hypoglycemic. Sulfonylureas, meglitinides and insulin antibodies should be sought in the plasma of any hypoglycemic patient.
El texto completo de este artículo está disponible en PDF.Key words : Hypoglycemia, hyperinsulinemia, insulinemia, NIPHS, factitious
Esquema
Vol 65 - N° 1
P. 88-95 - février 2004 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.