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dc.contributor.authorElghobashy, Maiar
dc.contributor.authorGama, Rousseau
dc.contributor.authorAinuddin Sulaiman, Raashda
dc.date.accessioned2024-03-28T12:25:35Z
dc.date.available2024-03-28T12:25:35Z
dc.date.issued2023-10-22
dc.identifier.citationElghobashy, M., Gama, R., and Sulaiman, R. A. (2023) Investigation and Causes of Spontaneous (Non-Diabetic) Hypoglycaemia in Adults: Pitfalls to Avoid. Diagnostics, 13 (20), Article Number 3275. https://doi.org/10.3390/diagnostics13203275en
dc.identifier.issn2075-4418en
dc.identifier.pmid37892096 (pubmed)
dc.identifier.doi10.3390/diagnostics13203275en
dc.identifier.urihttp://hdl.handle.net/2436/625453
dc.description© 2023 The Authors. Published by MDPI. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.3390/diagnostics13203275en
dc.description.abstractAlthough adult spontaneous (non-diabetic) hypoglycaemia is rare, its recognition is important for the preventative or curative treatment of the underlying cause. Establishing Whipple’s triad—low blood glucose, neuroglycopaenia and resolution of neuroglycopaenia on increasing blood glucose levels to normal or above—is essential to verify hypoglycaemia. Awareness that hypoglycaemia may occur in severely ill patients is important for its prevention. Further investigation in such cases is unnecessary unless another cause of hypoglycaemia is suspected. Patients are often asymptomatic and normoglycaemic at review. Their history of medication, self-medication, access to hypoglycaemic drugs, alcohol use and comorbidity may provide aetiological clues. The investigation involves obtaining blood samples during symptoms for laboratory glucose measurement or provoking fasting or postprandial hypoglycaemia as directed by symptoms. If confirmed, insulin, c-peptide, proinsulin and beta-hydroxybutyrate are analysed in hypoglycaemic samples. These will classify hypoglycaemia due to non-ketotic hyperinsulinaemia, non-ketotic hypoinsulinaemia and ketotic hypoinsulinaemia, and direct investigations to identify the underlying cause. There are, however, many pitfalls that may mislabel healthy individuals as “hypoglycaemic” or misdiagnose treatable or preventable causes of spontaneous hypoglycaemia. Clinical acumen and appropriate investigations will mostly identify hypoglycaemia and its cause.en
dc.description.sponsorshipThis research received no external funding.en
dc.formatapplication/pdfen
dc.languageeng
dc.language.isoenen
dc.publisherMDPI AGen
dc.relation.urlhttp://dx.doi.org/10.3390/diagnostics13203275en
dc.rightsLicence for published version: Creative Commons Attribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectadulten
dc.subjecthypoglycaemiaen
dc.subjectneuroglycopaeniaen
dc.subjectnon-diabeticen
dc.subjectspontaneous hypoglycaemiaen
dc.titleInvestigation and causes of spontaneous (non-diabetic) hypoglycaemia in adults: pitfalls to avoiden
dc.typeJournal articleen
dc.identifier.eissn2075-4418
dc.contributor.departmentSchool of Medicine and Clinical Practice, Wolverhampton University, Wolverhampton WV1 1LY, UKen
dc.identifier.journalDiagnosticsen
dc.date.updated2024-03-28T07:05:12Z
dc.contributor.institutionClinical Chemistry, Black Country Pathology Services, Royal Wolverhampton Trust, Wolverhampton WV10 0QP, UK.
pubs.place-of-publicationSwitzerland
dc.date.accepted2023-10-18
rioxxterms.funderUniversity of Wolverhamptonen
rioxxterms.identifier.projectUOW280324RGen
rioxxterms.versionVoRen
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/en
rioxxterms.licenseref.startdate2024-03-28en
dc.source.volume13
dc.source.issue20
dc.source.beginpage3275
dc.description.versionPublished version
refterms.dateFCD2024-03-28T12:23:05Z
refterms.versionFCDVoR
refterms.dateFOA2024-03-28T12:25:37Z


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Licence for published version: Creative Commons Attribution 4.0 International
Except where otherwise noted, this item's license is described as Licence for published version: Creative Commons Attribution 4.0 International