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Cited by 29Diabetes Management and ResearchPancreatic function and diabetesNeurological and metabolic disorders

Clinical Presentation and Diagnostic Approach to Hypoglycemia in Adults Without Diabetes Mellitus

Palani, Gurunanthan, Stortz, Ethan, Moheet, Amir·2023·Endocrine Practice
DOI 10.1016/j.eprac.2022.11.010
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Abstract

Objective To review the clinical presentation, causes, and diagnostic approach to spontaneous hypoglycemia in adults without diabetes mellitus. Methods A literature review was performed using the PubMed and Google Scholar databases. Results Hypoglycemia is uncommon in people who are not on glucose-lowering medications. Under normal physiologic conditions, multiple neural and hormonal counterregulatory mechanisms prevent the development of abnormally low levels of plasma glucose. If spontaneous hypoglycemia is suspected, the Whipple triad should be used to confirm hypoglycemia before pursuing further diagnostic workup. The Whipple criteria include the following: (1) low levels of plasma glucose, (2) signs or symptoms that would be expected with low levels of plasma glucose, and (3) improvement in those signs or symptoms when the level of plasma glucose increases. Spontaneous hypoglycemia can be caused by conditions that cause endogenous hyperinsulinism, including insulinoma, postbariatric hypoglycemia, and noninsulinoma pancreatogenous hypoglycemia. Spontaneous hypoglycemia can also be seen with critical illness, hepatic or renal dysfunction, hormonal deficiency, non-diabetes-related medications, and non-islet cell tumors. The initial diagnostic approach should begin by obtaining a detailed history of the nature and timing of the patient's symptoms, medications, underlying comorbid conditions, and any acute illness. A laboratory evaluation should be conducted at the time of th…

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Crossref · 10.1016/j.eprac.2022.11.010

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  • Symptoms of hypoglycemia can usually be categorized as neurogenic and neuroglycopenic.

    “Symptoms can usually be categorized as neurogenic and neuroglycopenic (Table 1) [3].”

    From Non-Diabetic Hypoglycemia: Evaluation and Management in Adults (2025) · cites this paper as [3]

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Authors
Palani, G., Stortz, E., & Moheet, A.
Affiliations
University of Minnesota (US)
Corresponding author
Moheet, Amir
ORCID
Venue
Endocrine Practice
Publisher
Elsevier BV
Published
2023-04
Volume
29
Issue
4
Pages
286-294
ISSN
1530-891X (ISSN-L)
DOI
10.1016/j.eprac.2022.11.010
OpenAlex
W4310701161
Cited by
29
References
19
Citations by year
2026: 9 · 2025: 10 · 2024: 8 · 2023: 2
FWCI
0.71
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Endocrine Practice (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Neurological and metabolic disorders
Keywords
spontaneous hypoglycemia, non-diabetic hypoglycemia, Whipple triad, endogenous hyperinsulinism, insulinoma, counterregulatory response, diagnostic workup, mixed meal tolerance test, critical illness, liver dysfunction, renal dysfunction, hormone deficiency, drug-induced hypoglycemia
MeSH terms
Adult, Blood Glucose, Diabetes Mellitus, Humans, Hypoglycemia, Insulinoma, Pancreatic Neoplasms

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