Template:Hypoglycemia DDX

Differential diagnosis of hypoglycemia

Hypoglycemia

Drugs

• Anti-hyperglycemic
  • Insulin
  • Oral secretagogue
    • Sulfonylurea toxicity
• Other
  • EtOH
  • B-blocker
  • ACEI
  • Acetaminophen (OD)

Systemic Illness

• Critical Illness
  • Sepsis
  • MI
• Organ Failure
  • Hepatic failure
  • Renal failure
• Endocrinopathy
  • Adrenal insufficiency
• Seizure
• Inborn errors of metabolism

Malignancy

• Insulinoma
• Non-islet cell
• Insulin/receptor autoantibodies
• High tumor burden

Other

• Artifactual
  • Specimen collection
  • Consumption
    • Leukemia
    • Erythrocytosis
    • Hemolytic disease
• Post-surgical
  • Gastric bypass
  • Gastrectomy
  • Pyloroplasty
• Starvation
  • Anorexia nervosa

Precipitants of anti-hyperglycemic induced hypoglycemia

• Decreased glucose
  • Missed meal
  • Consumption (exercise, illness)
• Increased drug
  • Error (patient, provider)
  • Intentional overdose
  • Increased availability
    • Hepatic failure
    • Renal failure
    • Drug interaction