Hypoglycemia

An abnormal decrease in plasma glucose concentration (<3.9 mmol/L or 70 mg/dL) to a level insufficient to meet metabolic demands, particularly cerebral glucose requirements, resulting in autonomic and neuroglycopenic manifestations.

Causes

• Patients with diabetes

  • Overdose: Insulin/sulfonylurea

  • Incorrect timing of medication relative to meals

  • Skipped or delayed meals

  • Excessive physical exercise without adequate carbohydrate intake

  • Alcohol consumption, especially without food intake

• Causes in people without diabetes

  • Alcohol consumption causing impaired hepatic glucose production

  • Accidental ingestion of diabetes medications

  • Critical illness

    • Liver failure

    • Kidney failure

    • Heart failure

    • Sepsis

• Endocrine causes

  • Adrenal insufficiency

  • Growth hormone deficiency

  • Hypopituitarism

  • Insulinoma

• Post-gastric bypass hypoglycemia

• Starvation/malnutrition

• Exercise-induced hypoglycemia