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Cited by 5Diabetes Management and ResearchPsychosomatic Disorders and Their TreatmentsSuicide and Self-Harm Studies

Prevalence and characteristics of factitious hypoglycaemia in non‐diabetic patients in a department of endocrinology

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Oueslati, Ibtissem, Terzi, Amani, Yazidi, Meriem, Kamoun, Elyes, Chihaoui, Melika·2022·Endocrinology, Diabetes & Metabolism
DOI 10.1002/edm2.375PMC PMC9659651
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Abstract

Introduction: Factitious hypoglycaemia is defined as the surreptitious use of insulin or oral hypoglycaemic agents to deliberately induce self‐harm. It represents a challenging diagnosis and misdiagnosis is associated with significant morbidity and mortality. The aim of this study was to assess the prevalence and the associated factors of factitious hypoglycaemia in non‐diabetic patients. Methods: This was a single‐centre, retrospective study including 70 non‐diabetic patients who were admitted for the investigation of hypoglycaemia. All patients fulfilled the Whipple triad. Epidemiological parameters, medical history, clinical and paraclinical data and the aetiology of hypoglycaemia were collected from medical records. Results: The diagnosis of factitious hypoglycaemia was held in 11 patients (9 women and 2 men) corresponding to a prevalence of 16%. It was secondary to intentional insulin use in six patients and the ingestion of glibenclamide in five patients. The median age of the patients was 28 years (interquartile range: 21–43). Two patients with factitious hypoglycaemia had a personal history of psychiatric disorders. The other causes of hypoglycaemia were adrenal insufficiency (34%), prediabetes (24%), insulinoma (6%), iatrogenic hypoglycaemia (10%), criminal hypoglycaemia (1%) and alcohol intoxication (2%). Age ≤ 35 years (Odds Ratio = 5.6, p = .017), family history of diabetes mellitus (Odds Ratio = 1.29, p = .015), attention disorders during hypoglycaemia (Odds Ratio = 12.5, p = .017) and fasting glucose level <0.7 g/L (Odds Ratio = 5.75, p = .017) were positively associated with factitious hypoglycaemia. Conclusion: Factors significantly associated with factitious hypoglycaemia were young age, family history of diabetes and a low fasting glucose level.

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  • Apart from severe diseases like liver, kidney or heart failure, the intake of alcohol, insulin, or insulin secretagogues needs to be ruled out.

    “Apart from severe diseases like liver, kidney or heart failure, the intake of alcohol, insulin, or insulin secretagogues needs to be ruled out [7,9,10].”

    From An Uncommon Cause of Recurrent Presyncope, Dizziness, and Tachycardia: A Case Report of Diffuse, Adult-Onset Nesidioblastosis/Non-Insulinoma Pancreatogenous Hypoglycemia Syndrome (NIPHS) (2023) · cites this paper as [10]

    The Introduction (page unavailable) identifies intentional insulin use and oral hypoglycaemic agents as causes of factitious hypoglycaemia; the Discussion describes testing to distinguish insulin use from sulfonylurea ingestion. The Results also list alcohol intoxication as a cause of hypoglycaemia. The paper does not specify liver, kidney or heart failure, or state the full rule-out recommendation as written. (LLM, conf=0.84)

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Research works printed but not linked: 23

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Authors
Oueslati, I., Terzi, A., Yazidi, M., Kamoun, E., & Chihaoui, M.
Affiliations
  • Hôpital La Rabta (TN)
  • Department of Endocrinology, La Rabta University Hospital, Faculty of Medicine University of Tunis‐El Manar Tunis Tunisia
Corresponding author
Oueslati, Ibtissem
ORCID
Venue
Endocrinology, Diabetes & Metabolism
Publisher
Wiley
Published
2022-09-18
Volume
5
Issue
6
Pages
e375-e375
ISSN
2398-9238 (ISSN-L)
DOI
10.1002/edm2.375
PMC
PMC9659651
OpenAlex
W4296331136
Cited by
5
References
1
Citations by year
2025: 2 · 2023: 2 · 2022: 1
FWCI
0.93
Type
journal article
Language
en
Open access
Licence
Locations
  • Endocrinology Diabetes & Metabolism (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Greater South Information System
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Keywords
glibenclamide, non-diabetic patients, prevalence, risk factors, family history of diabetes, young age, Whipple triad, misdiagnosis
MeSH terms
Adult, Diabetes Mellitus, Female, Glucose, Humans, Hypoglycemia, Insulin, Male, Pancreatic Neoplasms, Retrospective Studies, Prevalence

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