Overview

• Clinical syndrome present when the blood glucose falls below the normal fasting glucose range, generally <3.3 mmol/L
• Whipple’s Triad → low blood glucose concentration, hypoglycaemic symptoms & resolution of symptoms after raising blood glucose concentration to normal

Aetiology:

• Diabetic Patients ⇒ insulin or sulfonylurea use, fasting/missing meals
• Drugs ⇒ sulfonylureas and insulin, SGLT-2 inhibitors, DPP-4 inhibitors
• Hormone Deficiencies ⇒ hypopituitarism, adrenal insufficiency (Addison’s Disease)
• Insulinoma → excessive secretion of insulin due to tumour in pancreas
• Liver Failure
• Sepsis
• Amboss Overview

Making Diagnosis

Clinical Features:

• Increased Sympathetic Activity → sweating, anxiety, tachycardia, tremor, palpitations, pallor
• Increased Parasympathetic Activity → hunger, nausea, vomiting, paraesthesia
• Neuroglycopenic → confusion, seizures, agitation