Materiały źródłowe

• #1 Hypoglycemia – Symptoms, Causes and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/hypoglycemia

  Hypoglycemia develops when the level of blood glucose drops below 70 milligrams per deciliter (mg/dL) or 3.9 millimoles per liter (mmol/L) in diabetic people and below 55 mg/dL or 3.1 mmol/L for non-diabetics. […] For people with diabetes, these circumstances can lead to hypoglycemia. […] For people without diabetes, Non-diabetes-related hypoglycemia is of two types: reactive hypoglycemia and fasting hypoglycemia. […] Reactive hypoglycemia typically occurs approximately 2 – 4 hours after eating a meal of simple carbohydrates, which are rapidly broken down and absorbed, such as white rice, potatoes, white bread, cake, and pastries. […] Fasting hypoglycemia. Usually, the body has glucose storage as glycogen, so fasting does not cause hypoglycemia. Under certain circumstances fasting can lead to hypoglycemia as follows:

• #2 Hypoglycemia (Low Blood Sugar) in Cats | PetMD

  https://www.petmd.com/cat/conditions/endocrine/hypoglycemia-low-blood-sugar-cats

  Blood sugar, or glucose, is the main source of energy for both the body and the brain. Low levels of blood glucose, called hypoglycemia, will deprive the body and brain of energy, resulting in unconsciousness. If left untreated, it can lead to death. […] Hypoglycemia is the most common side effect of insulin administration for the treatment of diabetes. […] Cats under treatment for diabetes are at a higher risk for developing hypoglycemia. Mistakes that can be made when administering insulin include: […] Other causes of hypoglycemia in cats that are unrelated to the administration of insulin for diabetic patients include:

• #3 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors. […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia. […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #4 Hypoglycemia – Wikipedia

  https://en.wikipedia.org/wiki/Hypoglycemia

  Hypoglycemia is most common in those with diabetes treated by insulin, glinides, and sulfonylureas. […] The most common cause of hypoglycemia is medications used to treat diabetes such as insulin, sulfonylureas, and biguanides. […] Other causes of hypoglycemia include severe illness, sepsis, kidney failure, liver disease, hormone deficiency, tumors such as insulinomas or non-B cell tumors, inborn errors of metabolism, and several medications. […] Hypoglycemia is rare in those without diabetes, because there are many regulatory mechanisms in place to appropriately balance glucose, insulin, and glucagon. […] Other causes of hypoglycemia in diabetics include fasting, exercising more than usual, drinking alcohol, and kidney disease. […] Serious illness may result in low blood sugar. […] Sepsis, a common cause of hypoglycemia in serious illness, can lead to hypoglycemia through many ways.

• #5 Hypoglycemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/hypoglycemia

  Hypoglycemia in patients without diabetes is rare. It can occur in the fasting or in the postprandial state (1 to 3 hours after eating) and can be classified as insulin-mediated or non-insulin-mediated. […] Insulin-mediated causes include exogenous insulin, insulin secretagogue (sulfonylurea; eg, glyburide, glipizide, glimepiride) use, insulinoma, post-bariatric surgery hypoglycemia, non-insulinoma pancreatogenous hypoglycemia syndrome (NIPHS), and insulin autoimmune hypoglycemia. […] Non-insulin-mediated causes include adrenal insufficiency and the use of medications other than insulin or a sulfonylurea (eg, quinine, gatifloxicin, pentamidine, alcohol). […] In patients who are ill and hospitalized, spontaneous hypoglycemia that is not caused by medications can occur when poor nutrition is combined with advanced organ failure (especially liver, kidney, or heart failure) and/or sepsis. […] Non-islet cell tumor hypoglycemia is a rare condition caused by production of large amounts of aberrant forms of insulin-like growth factor 2 (IGF-2) by a tumor. […] Factitious hypoglycemia is true hypoglycemia induced by nontherapeutic administration of sulfonylureas or insulin.

• #6 Drug-induced low blood sugar: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000310.htm

  Drug-induced low blood sugar is low blood glucose that results from taking medicine. […] Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes. […] Other than certain medicines, the following can also cause blood sugar (glucose) level to drop: Drinking alcohol, Getting more activity than usual, Intentionally or unintentionally overdosing on the medicines used to treat diabetes, Missing meals. […] Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in drug-induced low blood sugar. […] The condition may also occur when someone without diabetes takes a medicine used to treat diabetes. […] In rare cases, non-diabetes-related medicines can cause low blood sugar. […] Medicines that can cause drug-induced low blood sugar include: Beta-blockers (such as atenolol, or propranolol overdose), Cibenzoline and quinidine (heart arrhythmia drugs), Glinides (such as nateglinide and repaglinide), Indomethacin (a pain reliever), Insulin, Metformin when used with sulfonylureas, SGLT2 inhibitors (such as canagliflozin, dapagliflozin, empagliflozin and ertugliflozin) with or without sulfonylureas, Sulfonylureas (such as glipizide, glimepiride, glyburide), Thiazolidinediones (such as pioglitazone and rosiglitazone) when used with sulfonylureas, Drugs that fight infections (such as gatifloxacin, levofloxacin, pentamidine, quinine, trimethoprim-sulfamethoxazole).

• #7 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] Common situations that can lead to hypoglycemia for people with diabetes include: Taking too much insulin, the wrong insulin or injecting it into your muscle instead of in your fat tissue. […] What causes hypoglycemia in people without diabetes? There are two main types of non-diabetes-related hypoglycemia: reactive hypoglycemia and fasting hypoglycemia. […] Reactive hypoglycemia happens when you experience low blood sugar after a meal. It typically occurs about two to four hours after a meal. […] Researchers dont yet know the exact cause. But they think it happens due to a sudden spike and then fall in blood sugar after eating certain foods, especially simple carbohydrate foods like white rice, potatoes, white bread, cake and pastries.

• #8 Low Blood Sugar (Hypoglycemia) | Diabetes | CDC

  https://www.cdc.gov/diabetes/about/low-blood-sugar-hypoglycemia.html

  Low blood sugar can be dangerous if left untreated. […] Low blood sugar is especially common in people with type 1 diabetes. […] Knowing how to spot low blood sugar is important because it can be dangerous if left untreated. […] Reasons this may happen include: Taking too much insulin. […] There are many reasons why you may have low blood sugar, including: Taking too much insulin. […] Not eating enough carbohydrates for how much insulin you take. […] Timing of when you take your insulin. […] The amount and timing of physical activity. […] Drinking alcohol. […] Hot and humid weather. […] Unexpected changes in your schedule. […] Spending time at a high altitude. […] Going through puberty. […] Having your period (menstruation).

• #9 Diabetic hypoglycemia – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525

  Diabetic hypoglycemia occurs when someone with diabetes doesn’t have enough sugar (glucose) in his or her blood. […] Low blood sugar is most common among people who take insulin, but it can also occur if you’re taking certain oral diabetes medications. […] Common causes of diabetic hypoglycemia include: Taking too much insulin or diabetes medication, Not eating enough, Postponing or skipping a meal or snack, Increasing exercise or physical activity without eating more or adjusting your medications, Drinking alcohol. […] If you have type 1 or type 2 diabetes and need insulin to control your blood sugar, taking more insulin than you need can cause your blood sugar level to drop too low and result in hypoglycemia. […] Your blood sugar can also drop too low if, after taking your diabetes medication, you eat less than usual, or if you exercise more than you typically do, which uses extra glucose.

• #10 Causes and How to Prevent Hypoglycemia (Low Blood Glucose) | American Diabetes Association

  https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/causes-prevention

  Hypoglycemia (or low blood glucose) is common for people with type 1 diabetes. It also can occur in people with type 2 diabetes taking insulin or certain diabetes medications. […] Too much insulin or certain diabetes medications is a common cause of low blood glucose. Miscalculating for how many carbs you’ve eating can lead to giving too much insulin, resulting in a low. […] What you eat or drink can has a big impact on your glucose levels. Sometimes, it can lead to a low when the following occurs. […] Physical activity and exercise can lower your blood glucose. Also, more intense physical activity or exercise than usual can make your body more sensitive to insulin and lower your blood glucose levels after you’re done. […] Your best bet is to keep your blood glucose in your target range. Keep track of your personal symptoms you feel when go low. If you start to recognize those feelings, you can act faster to treat your low glucose before it drops lower. […] The average person with type 1 diabetes has low blood glucose levels up to twice a week. Learn what causes and lows and what you can do to prevent them.

• #11 Hypoglycemia and Diabetes (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/hypoglycemia.html

  When blood glucose levels (called blood sugar levels) drop too low, it’s called hypoglycemia. […] Hypoglycemia can happen for different reasons. Anyone with diabetes can get low blood sugar, even people who follow their care plan carefully. Sugar levels can drop if your child: […] skips or delays meals or snacks or doesn’t eat as much carbohydrate-containing food as expected when taking their diabetes medicine. This happens often in kids who develop an illness (such as a stomach virus) that causes loss of appetite, nausea, or vomiting. […] takes too much insulin, takes the wrong type of insulin, or takes insulin at the wrong time […] exercises more than usual without eating extra snacks or adjusting the dosage of diabetes medicines.

• #12 Avoiding Nighttime Hypoglycemia | Joslin Diabetes Center

  https://joslin.org/news-stories/all-news-stories/education/2020/03/avoiding-nighttime-hypoglycemia

  Nighttime hypoglycemia can be the result of a number of factors in people with diabetes. It is important to learn what causes hypoglycemia (low glucose) in order to prevent it from happening. […] Having an active day or exercising close to bedtime with diabetes can lower glucose and cause hypoglycemic during sleep or overnight. Other factors that can put you at risk for nighttime hypoglycemia are too much basal (background) insulin or consuming alcohol in the evening. While your liver is busy clearing the alcohol from your blood it stops producing glucose putting one at risk for having a lower glucose level. […] Some people forget that their premeal (fast-acting) insulin can last for up to five to six hours. If you eat a late dinner and go to sleep a few hours later, your glucose may be okay before going to bed. However, since the insulin you took for dinner is still working in your body, your glucose could drop during the night.

• #13 Low blood sugar (hypoglycaemia)

  https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/

  Low blood sugar usually affects people with diabetes who take insulin or some other diabetes medicines. It’s rare in people without diabetes. […] Diabetes causes high blood sugar (hyperglycaemia). Diabetes medicines treat your condition by lowering your blood sugar, but they can sometimes make it go too low. […] You’re more likely to get low blood sugar if you: take too much insulin; have problems with the way you inject insulin, such as injecting in the same place too often; miss or delay meals, or do not eat enough carbohydrate; do a lot of exercise without eating more carbohydrate or reducing your insulin dose; drink a lot of alcohol, particularly without eating. […] It’s rare to get low blood sugar if you do not have diabetes. It can sometimes be caused by conditions including: malnutrition; Addison’s disease; a growth (tumour) in your pancreas.

• #14 Causes and Risk Factors of Hypoglycemia

  https://www.verywellhealth.com/hypoglycemia-causes-risk-factors-1087616

  If you have diabetes, however, and you exercise without eating, exercise more than you normally do, or you delay your meal, you may become hypoglycemic. […] Taking too much insulin or oral diabetes medication can cause hypoglycemia. […] If you’re taking insulin or an oral diabetes medication, drinking alcohol can cause hypoglycemia. […] Losing weight can make you more sensitive to insulin, resulting in needing less or no medication. […] It’s important to realize that the tighter your glucose control, the higher your risk of hypoglycemia, especially early in treatment. […] One complication of diabetes is kidney disease, which can result in your kidneys taking longer to clear insulin from your system. This can potentially result in hypoglycemia. […] Hypoglycemia is a rare condition in people without diabetes. If you don’t have diabetes and you develop hypoglycemia, this indicates that something else is going on in your body.

• #15 Causes and Risk Factors of Hypoglycemia

  https://www.verywellhealth.com/hypoglycemia-causes-risk-factors-1087616

  If you have diabetes, however, and you exercise without eating, exercise more than you normally do, or you delay your meal, you may become hypoglycemic. […] Taking too much insulin or oral diabetes medication can cause hypoglycemia. […] If you’re taking insulin or an oral diabetes medication, drinking alcohol can cause hypoglycemia. […] Losing weight can make you more sensitive to insulin, resulting in needing less or no medication. […] It’s important to realize that the tighter your glucose control, the higher your risk of hypoglycemia, especially early in treatment. […] One complication of diabetes is kidney disease, which can result in your kidneys taking longer to clear insulin from your system. This can potentially result in hypoglycemia. […] Hypoglycemia is a rare condition in people without diabetes. If you don’t have diabetes and you develop hypoglycemia, this indicates that something else is going on in your body.

• #16 Low Blood Sugar (Hypoglycemia) | Diabetes | CDC

  https://www.cdc.gov/diabetes/about/low-blood-sugar-hypoglycemia.html

  Low blood sugar can be dangerous if left untreated. […] Low blood sugar is especially common in people with type 1 diabetes. […] Knowing how to spot low blood sugar is important because it can be dangerous if left untreated. […] Reasons this may happen include: Taking too much insulin. […] There are many reasons why you may have low blood sugar, including: Taking too much insulin. […] Not eating enough carbohydrates for how much insulin you take. […] Timing of when you take your insulin. […] The amount and timing of physical activity. […] Drinking alcohol. […] Hot and humid weather. […] Unexpected changes in your schedule. […] Spending time at a high altitude. […] Going through puberty. […] Having your period (menstruation).

• #17 Low Blood Sugar (Hypoglycemia) – Breakthrough T1D

  https://www.breakthrought1d.org/t1d-basics/symptoms/low-blood-sugar/

  When you have too little sugar in your blood, it is called low blood sugar, or hypoglycemia. […] Common causes of hypoglycemia include: Taking too much insulin, A mismatch between the carbs eaten and the amount of insulin you take, Timing of the insulin dose, Physical activity. […] Sometimes, hypoglycemia is caused by things you cannot control, including: Hot and humid weather, Interruptions in usual schedule, High altitude, Going through puberty, Having your menstrual period. […] Glucagon is generally used when a person with T1D is experiencing a severely low glucose level and is unable to swallow to treat with rapid-acting carbohydrates (e.g., juice), unconscious, or having a hypoglycemic seizure.

• #18 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia occurs when your blood sugar (glucose) level falls too low for bodily functions to continue. There are several reasons why this can happen. The most common reason for low blood sugar is a side effect of medications used to treat diabetes. […] Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia.

• #19 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors. […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia. […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #20 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia occurs when your blood sugar (glucose) level falls too low for bodily functions to continue. There are several reasons why this can happen. The most common reason for low blood sugar is a side effect of medications used to treat diabetes. […] Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia.

• #21 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia occurs when your blood sugar (glucose) level falls too low for bodily functions to continue. There are several reasons why this can happen. The most common reason for low blood sugar is a side effect of medications used to treat diabetes. […] Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia.

• #22 Hypoglycemia (Low Blood Sugar): Symptoms, Causes, Treatment, Diet

  https://www.webmd.com/diabetes/hypoglycemia-overview

  Hypoglycemia is a condition caused by low blood glucose (blood sugar) levels. […] The condition is most common in people with diabetes who have issues with medicine, food, or exercise. But sometimes people who don’t have diabetes can also get low blood sugar. […] There are two kinds of nondiabetic hypoglycemia: Reactive hypoglycemia, which happens a few hours after you eat a meal, and Fasting hypoglycemia, which might be linked to medicine or a disease. […] Usually, low blood sugar affects people with diabetes. But there are some reasons that you could have it without diabetes, including: Certain medications. Some medicines, such as the malaria drug quinine (Qualaquin), can cause low blood sugar. […] Some diseases. Severe hepatitis, cirrhosis, kidney failure, major infections, and heart disease can affect blood sugar.

• #23 Drug-induced low blood sugar: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000310.htm

  Drug-induced low blood sugar is low blood glucose that results from taking medicine. […] Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes. […] Other than certain medicines, the following can also cause blood sugar (glucose) level to drop: Drinking alcohol, Getting more activity than usual, Intentionally or unintentionally overdosing on the medicines used to treat diabetes, Missing meals. […] Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in drug-induced low blood sugar. […] The condition may also occur when someone without diabetes takes a medicine used to treat diabetes. […] In rare cases, non-diabetes-related medicines can cause low blood sugar. […] Medicines that can cause drug-induced low blood sugar include: Beta-blockers (such as atenolol, or propranolol overdose), Cibenzoline and quinidine (heart arrhythmia drugs), Glinides (such as nateglinide and repaglinide), Indomethacin (a pain reliever), Insulin, Metformin when used with sulfonylureas, SGLT2 inhibitors (such as canagliflozin, dapagliflozin, empagliflozin and ertugliflozin) with or without sulfonylureas, Sulfonylureas (such as glipizide, glimepiride, glyburide), Thiazolidinediones (such as pioglitazone and rosiglitazone) when used with sulfonylureas, Drugs that fight infections (such as gatifloxacin, levofloxacin, pentamidine, quinine, trimethoprim-sulfamethoxazole).

• #24 Hypoglycemia – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism/hypoglycemia

  Hypoglycemia is most often caused by medications taken to control diabetes. Much less common causes of hypoglycemia include other medications, critical illness or organ failure, a reaction to carbohydrates (in susceptible people), an insulin-producing tumor in the pancreas, and some types of bariatric (weight loss) surgery. […] Most cases of hypoglycemia occur in people with diabetes and are caused by insulin or other medications (especially, sulfonylureas such as glyburide, glipizide, and glimepiride) that they take to lower the levels of glucose in their blood. […] Certain medications other than those for diabetes, most notably pentamidine, used to treat a form of pneumonia that occurs most often as part of AIDS, and quinine, used to treat muscle cramps, occasionally cause hypoglycemia.

• #25 Drug-induced low blood sugar: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000310.htm

  Drug-induced low blood sugar is low blood glucose that results from taking medicine. […] Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes. […] Other than certain medicines, the following can also cause blood sugar (glucose) level to drop: Drinking alcohol, Getting more activity than usual, Intentionally or unintentionally overdosing on the medicines used to treat diabetes, Missing meals. […] Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in drug-induced low blood sugar. […] The condition may also occur when someone without diabetes takes a medicine used to treat diabetes. […] In rare cases, non-diabetes-related medicines can cause low blood sugar. […] Medicines that can cause drug-induced low blood sugar include: Beta-blockers (such as atenolol, or propranolol overdose), Cibenzoline and quinidine (heart arrhythmia drugs), Glinides (such as nateglinide and repaglinide), Indomethacin (a pain reliever), Insulin, Metformin when used with sulfonylureas, SGLT2 inhibitors (such as canagliflozin, dapagliflozin, empagliflozin and ertugliflozin) with or without sulfonylureas, Sulfonylureas (such as glipizide, glimepiride, glyburide), Thiazolidinediones (such as pioglitazone and rosiglitazone) when used with sulfonylureas, Drugs that fight infections (such as gatifloxacin, levofloxacin, pentamidine, quinine, trimethoprim-sulfamethoxazole).

• #26 Hypoglycemia Differential Diagnoses

  https://emedicine.medscape.com/article/122122-differential

  Because the consequences of hypoglycemia can be devastating and an antidote is readily available, diagnosis and treatment must be rapid in any patient with suspected hypoglycemia, regardless of the cause. […] Conditions such as Jamaican vomiting sickness, ingestion of ethanol-containing mouthwash or cologne (children), gastric surgery, potassium administration during periodic attacks of paralysis, excessive muscular activity, diarrhea (childhood) can also cause hypoglycemia. […] Hepatic disease: (eg, hepatic failure, cirrhosis, galactose intolerance, fructose intolerance, glycogen storage diseases) […] Endocrine disorders (eg, pheochromocytoma, Addison disease, glucagon deficiency, carcinomas, extrahepatic tumors) […] Hypoglycemic agents (eg, insulin, oral hypoglycemic agents) […] Nutritional disorders (eg, prolonged starvation before anesthesia, protein calorie malnutrition, L-leucine-sensitive hypoglycemic defect in children, low-calorie ketogenic diet, renal disease) […] Autoimmune disorders (eg, Graves disease) […] Substance abuse (eg, cocaine, ethanol, salicylates, beta-blockers, pentamidine).

• #27 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #28 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  Counter-regulatory hormone deficiencies can occur in states of adrenal insufficiency. Hypoglycemia associated with such deficiencies is rare. Non-islet cell tumors may also cause hypoglycemia by increased insulin-like growth factor 2 (IGF-2) secretion. […] Insulinomas are hyperfunctioning islet cell tumors associated with increased insulin secretion. They can be life-threatening and primarily manifest with fasting morning hypoglycemia. Although these tumors are rare, they should be a consideration in the workup of suspected cases.

• #29 Hypoglycemia – Symptoms, Causes and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/hypoglycemia

  Excessive alcohol consumption: Alcohol interferes with gluconeogenesis, a process whereby the body produces new glucose. […] Critical illness: Conditions like end-stage liver disease, sepsis, starvation, or kidney failure can deplete stored glucose faster than the body can generate new glucose from food. […] Adrenal insufficiency: It can cause insufficient cortisol production, contributing to episodes of hypoglycemia. […] Non-islet cell tumor hypoglycemia (NICTH): NICTH tumors release excess insulin-like growth factor 2 (IGF-2), a hormone with insulin-like effects, causing low blood sugar. […] Insulinoma: Insulinoma is a tumor in the pancreas that produces excessive insulin, causing hypoglycemia commonly occurring in the early morning. […] Certain medications: Medications such as beta-blockers and certain antibiotics can induce hypoglycemia.

• #30 Hypoglycemia – Symptoms, Causes and Treatment | MedPark Hospital

  https://www.medparkhospital.com/en-US/disease-and-treatment/hypoglycemia

  Excessive alcohol consumption: Alcohol interferes with gluconeogenesis, a process whereby the body produces new glucose. […] Critical illness: Conditions like end-stage liver disease, sepsis, starvation, or kidney failure can deplete stored glucose faster than the body can generate new glucose from food. […] Adrenal insufficiency: It can cause insufficient cortisol production, contributing to episodes of hypoglycemia. […] Non-islet cell tumor hypoglycemia (NICTH): NICTH tumors release excess insulin-like growth factor 2 (IGF-2), a hormone with insulin-like effects, causing low blood sugar. […] Insulinoma: Insulinoma is a tumor in the pancreas that produces excessive insulin, causing hypoglycemia commonly occurring in the early morning. […] Certain medications: Medications such as beta-blockers and certain antibiotics can induce hypoglycemia.

• #31 Low blood sugar (hypoglycaemia)

  https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/

  Low blood sugar usually affects people with diabetes who take insulin or some other diabetes medicines. It’s rare in people without diabetes. […] Diabetes causes high blood sugar (hyperglycaemia). Diabetes medicines treat your condition by lowering your blood sugar, but they can sometimes make it go too low. […] You’re more likely to get low blood sugar if you: take too much insulin; have problems with the way you inject insulin, such as injecting in the same place too often; miss or delay meals, or do not eat enough carbohydrate; do a lot of exercise without eating more carbohydrate or reducing your insulin dose; drink a lot of alcohol, particularly without eating. […] It’s rare to get low blood sugar if you do not have diabetes. It can sometimes be caused by conditions including: malnutrition; Addison’s disease; a growth (tumour) in your pancreas.

• #32 Hypoglycemia – Wikipedia

  https://en.wikipedia.org/wiki/Hypoglycemia

  Other causes of serious illness that may cause hypoglycemia include liver failure and kidney failure. […] A number of medications have been identified which may cause hypoglycemia, through a variety of ways. […] If a person without diabetes accidentally takes medications that are traditionally used to treat diabetes, this may also cause hypoglycemia. […] When individuals take insulin without needing it, to purposefully induce hypoglycemia, this is referred to as surreptitious insulin use or factitious hypoglycemia. […] The production of glucose is blocked by alcohol. […] Children with primary adrenal failure, also called Addison’s disease, may experience hypoglycemia after long periods of fasting. […] Hypopituitarism, leading to decreased growth hormone, is another cause of hypoglycemia in children, particularly with long periods of fasting or increased exercise.

• #33 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  Counter-regulatory hormone deficiencies can occur in states of adrenal insufficiency. Hypoglycemia associated with such deficiencies is rare. Non-islet cell tumors may also cause hypoglycemia by increased insulin-like growth factor 2 (IGF-2) secretion. […] Insulinomas are hyperfunctioning islet cell tumors associated with increased insulin secretion. They can be life-threatening and primarily manifest with fasting morning hypoglycemia. Although these tumors are rare, they should be a consideration in the workup of suspected cases.

• #34 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  For the majority of people without diabetes, not eating food for a long time (fasting) doesnt lead to hypoglycemia. This is because your body uses hormones and stored glucose to manage your blood sugar. […] However, certain conditions and situations can lead to fasting hypoglycemia in people without diabetes, including: Excessive alcohol consumption: Alcohol prevents your body from forming new glucose cells (gluconeogenesis). […] Adrenal insufficiency causes lower-than-normal cortisol levels. As cortisol (a hormone) helps regulate your blood sugar by increasing it, having low levels of cortisol can lead to hypoglycemia episodes. […] Non-islet cell tumor hypoglycemia (NICTH): This is a rare but serious syndrome in which a tumor releases excess insulin-like growth factor 2 (IGF-2). […] An insulinoma is a rare tumor in your pancreas that produces excess insulin. It leads to hypoglycemia episodes most commonly in the early morning.

• #35 Hypoglycemia: MedlinePlus

  https://medlineplus.gov/hypoglycemia.html

  Hypoglycemia is common in people who have diabetes type 1 or who have diabetes type 2 and take insulin or other diabetes medicines. It can happen: […] Although it’s rare, you can still get low blood glucose without having diabetes. The causes can include conditions such as liver disease, kidney disease, and hormone deficiencies (lack of certain hormones). It can also happen in people who have had certain types of weight loss surgery. Some medicines, such as certain heart medicines and antibiotics, can also cause it.

• #36 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia occurs when your blood sugar (glucose) level falls too low for bodily functions to continue. There are several reasons why this can happen. The most common reason for low blood sugar is a side effect of medications used to treat diabetes. […] Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia.

• #37 Hypoglycemia (Low Blood Sugar): Symptoms, Causes, Treatment, Diet

  https://www.webmd.com/diabetes/hypoglycemia-overview

  Hypoglycemia is a condition caused by low blood glucose (blood sugar) levels. […] The condition is most common in people with diabetes who have issues with medicine, food, or exercise. But sometimes people who don’t have diabetes can also get low blood sugar. […] There are two kinds of nondiabetic hypoglycemia: Reactive hypoglycemia, which happens a few hours after you eat a meal, and Fasting hypoglycemia, which might be linked to medicine or a disease. […] Usually, low blood sugar affects people with diabetes. But there are some reasons that you could have it without diabetes, including: Certain medications. Some medicines, such as the malaria drug quinine (Qualaquin), can cause low blood sugar. […] Some diseases. Severe hepatitis, cirrhosis, kidney failure, major infections, and heart disease can affect blood sugar.

• #38 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors. […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia. […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #39 Hypoglycemia: MedlinePlus

  https://medlineplus.gov/hypoglycemia.html

  Hypoglycemia is common in people who have diabetes type 1 or who have diabetes type 2 and take insulin or other diabetes medicines. It can happen: […] Although it’s rare, you can still get low blood glucose without having diabetes. The causes can include conditions such as liver disease, kidney disease, and hormone deficiencies (lack of certain hormones). It can also happen in people who have had certain types of weight loss surgery. Some medicines, such as certain heart medicines and antibiotics, can also cause it.

• #40 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia occurs when your blood sugar (glucose) level falls too low for bodily functions to continue. There are several reasons why this can happen. The most common reason for low blood sugar is a side effect of medications used to treat diabetes. […] Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia.

• #41 Hypoglycaemia (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/hypoglycaemia

  There are many causes of hypoglycaemia but it is most commonly the result of an excess of either insulin or oral hypoglycaemic medications combined with reduced sugar intake or increased activity. Hypoglycaemia adversely affects quality of life in patients with diabetes. […] Alcohol is the most common non-iatrogenic (non-physician) cause of hypoglycaemia in adults. […] People with diabetes treated with insulin or sulfonylureas: Recurrent hypoglycaemia often responds to changes in diet or treatment but referral for structured education may be required (eg, to a Diabetes Specialist Nurse or a local education programme). […] People with diabetes may develop impaired awareness of hypoglycaemia. […] People with diabetes with poor glycaemic control may experience hypoglycaemic symptoms with normal glucose concentrations (’false hypoglycaemia’).

• #42 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors. […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia. […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #43 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors. […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia. […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #44 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia occurs when your blood sugar (glucose) level falls too low for bodily functions to continue. There are several reasons why this can happen. The most common reason for low blood sugar is a side effect of medications used to treat diabetes. […] Hypoglycemia in people without diabetes is much less common. Causes can include: […] Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, especially in children or in people with kidney failure. One example is quinine (Qualaquin), used to treat malaria. […] Drinking heavily without eating can keep the liver from releasing glucose from its glycogen stores into the bloodstream. This can lead to hypoglycemia. […] Severe liver illnesses such as severe hepatitis or cirrhosis, severe infection, kidney disease, and advanced heart disease can cause hypoglycemia.

• #45 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] Common situations that can lead to hypoglycemia for people with diabetes include: Taking too much insulin, the wrong insulin or injecting it into your muscle instead of in your fat tissue. […] What causes hypoglycemia in people without diabetes? There are two main types of non-diabetes-related hypoglycemia: reactive hypoglycemia and fasting hypoglycemia. […] Reactive hypoglycemia happens when you experience low blood sugar after a meal. It typically occurs about two to four hours after a meal. […] Researchers dont yet know the exact cause. But they think it happens due to a sudden spike and then fall in blood sugar after eating certain foods, especially simple carbohydrate foods like white rice, potatoes, white bread, cake and pastries.

• #46 Hypoglycemia (Low Blood Sugar): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar

  Hypoglycemia happens when your blood sugar drops below a healthy range. Several factors can contribute to this for people with diabetes. Hypoglycemia can develop if things like food, exercise and diabetes medications are out of balance. […] Common situations that can lead to hypoglycemia for people with diabetes include: Taking too much insulin, the wrong insulin or injecting it into your muscle instead of in your fat tissue. […] What causes hypoglycemia in people without diabetes? There are two main types of non-diabetes-related hypoglycemia: reactive hypoglycemia and fasting hypoglycemia. […] Reactive hypoglycemia happens when you experience low blood sugar after a meal. It typically occurs about two to four hours after a meal. […] Researchers dont yet know the exact cause. But they think it happens due to a sudden spike and then fall in blood sugar after eating certain foods, especially simple carbohydrate foods like white rice, potatoes, white bread, cake and pastries.

• #47 Hypoglycemia – Wikipedia

  https://en.wikipedia.org/wiki/Hypoglycemia

  Inborn errors of metabolism may cause infant hypoglycemia, and much less commonly adult hypoglycemia. […] A primary B-cell tumor, such as an insulinoma, is associated with hypoglycemia. […] Hypoglycemia may occur in people with non-B cell tumors such as hepatomas, adrenocorticoid carcinomas, and carcinoid tumors. […] The Roux-en-Y gastric bypass has been associated with hypoglycemia, called post-gastric bypass postprandial hypoglycemia. […] Antibodies can be formed against insulin, leading to autoimmune hypoglycemia. […] Low blood sugar may occur in healthy neonates aged less than 48 hours who have not eaten for a few hours.

• #48 Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122122-overview

  Causes of hypoglycemia are varied, but it is seen most often in diabetic patients. Hypoglycemia may result from medication changes or overdoses, infection, diet changes, metabolic changes over time, or activity changes; however, no acute cause may be found. Other causes include alimentary problems, idiopathic causes, fasting, insulinoma, endocrine problems, extrapancreatic causes, hepatic disease, and bariatric surgery, along with additional miscellaneous etiologies. […] A study by van Furth et al indicated that both dumping syndrome and postbariatric surgery hypoglycemia can be attributed to a common etiology, with glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) being key to the development of each. […] True loss of consciousness is highly suggestive of an etiology other than reactive hypoglycemia.

• #49 Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122122-overview

  Causes of hypoglycemia are varied, but it is seen most often in diabetic patients. Hypoglycemia may result from medication changes or overdoses, infection, diet changes, metabolic changes over time, or activity changes; however, no acute cause may be found. Other causes include alimentary problems, idiopathic causes, fasting, insulinoma, endocrine problems, extrapancreatic causes, hepatic disease, and bariatric surgery, along with additional miscellaneous etiologies. […] A study by van Furth et al indicated that both dumping syndrome and postbariatric surgery hypoglycemia can be attributed to a common etiology, with glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) being key to the development of each. […] True loss of consciousness is highly suggestive of an etiology other than reactive hypoglycemia.

• #50 Hypoglycemia (Low Blood Sugar): Symptoms, Causes, Treatment, Diet

  https://www.webmd.com/diabetes/hypoglycemia-overview

  Malnutrition. Long-term starvation, such as when you have anorexia, can cause your body to use up its backup glycogen stores. […] Drinking too much alcohol. If you drink too much alcohol without eating, the liver can’t break down its backup glycogen supply into glucose. […] Some cancers. Certain pancreatic tumors can cause your body to make too much insulin. […] Hormone issues. Some disorders, especially of the adrenal and pituitary glands, can affect hormones such as insulin and glucagon. […] Reactive hypoglycemia is when you have low blood sugar within 2-4 hours after eating. […] This is a type of hypoglycemia caused by fasting (not eating for a long time). […] When you have diabetes, your body has a hard time making or using insulin. […] Treatment usually includes insulin or other drugs to help manage your blood sugar.

• #51 Hypoglycemia – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

  Hypoglycemia can occur with malnutrition and starvation when you don’t get enough food, and the glycogen stores your body needs to create glucose are used up. […] A rare tumor of the pancreas (insulinoma) can cause you to produce too much insulin, resulting in hypoglycemia. […] Certain adrenal gland and pituitary tumor disorders can result in an inadequate amount of certain hormones that regulate glucose production or metabolism.

• #52 Causes and Risk Factors of Hypoglycemia

  https://www.verywellhealth.com/hypoglycemia-causes-risk-factors-1087616

  Hypoglycemia can be caused by certain medications, especially in children or people with kidney failure. […] If you don’t eat enough or don’t eat at all and you drink an excessive amount of alcohol, especially over the course of a few days, you may become hypoglycemic. […] Kidney disorders, severe hepatitis, long-term anorexia, malaria, and sepsis (a complication of getting an infection) are all illnesses that can potentially cause hypoglycemia. […] Adrenal disorders such as Addison’s disease and certain pituitary disorders can cause hypoglycemia, as well as not having enough growth hormone in children. […] Some people have an overproduction of insulin that can cause hypoglycemia. Certain tumors may cause this overproduction, as can enlarged and more numerous beta cells in the pancreas.

• #53

• #54 Hypoglycemia – Wikipedia

  https://en.wikipedia.org/wiki/Hypoglycemia

  Hypoglycemia is most common in those with diabetes treated by insulin, glinides, and sulfonylureas. […] The most common cause of hypoglycemia is medications used to treat diabetes such as insulin, sulfonylureas, and biguanides. […] Other causes of hypoglycemia include severe illness, sepsis, kidney failure, liver disease, hormone deficiency, tumors such as insulinomas or non-B cell tumors, inborn errors of metabolism, and several medications. […] Hypoglycemia is rare in those without diabetes, because there are many regulatory mechanisms in place to appropriately balance glucose, insulin, and glucagon. […] Other causes of hypoglycemia in diabetics include fasting, exercising more than usual, drinking alcohol, and kidney disease. […] Serious illness may result in low blood sugar. […] Sepsis, a common cause of hypoglycemia in serious illness, can lead to hypoglycemia through many ways.

• #55 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors. […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia. […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

• #56 Hypoglycemia in Pancreatic Disease | Pancreapedia

  https://pancreapedia.org/reviews/hypoglycemia-in-pancreatic-disease

  Plasma glucose is maintained in a narrow range (~60 to ~120 mg/dl or 3.3 to 6.7 mmol). Glucose that falls significantly below this concentration is a potentially life threatening medical emergency. Severe hypoglycemia is associated with increased mortality in diabetic patients (23). […] Hypoglycemia is almost always the result of excess insulin and occurs most commonly in persons with diabetes. It is generally the result of an unintended overdose with exogenous insulin. It can also result from intentional overdoses and oral hypoglycemic drugs. […] Rarely, the primary disorder leading to hypoglycemia is impaired glucose production. These causes of hypoglycemia include inborn errors of metabolism, certain medications, advanced hepatic and renal diseases, certain poisons, and alcoholic ketoacidosis.

• #57 Non-Diabetic Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK573079/

  Hypoglycemia is uncommonly seen in adults without diabetes mellitus. However, all patients should undergo evaluation and management who develop symptoms and/or signs of hypoglycemia (Whipple’s triad), evidence of low blood glucose (55 mg/dL), and resolution of symptoms and/or signs after an increase in blood glucose level. […] Hypoglycemia can be broadly divided into two main groups: Insulin-mediated (hyperinsulinism) and Independent of insulin. […] The endogenous cause of hypoglycemia due to hyperinsulinism in a non-diabetic adult is secondary to Insulinoma and islet cell hyperplasia (nesidioblastosis). […] Insulin independent hypoglycemia includes alcohol, visceral failure (liver/renal failure), critical illness, primary adrenal failure, anterior pituitary failure, severe sepsis, cerebral malaria, anorexia nervosa, glycogen storage disease, post-bariatric surgery, mesenchymal tumors with elevated IGF-2 levels, autoimmune hypoglycemia secondary to anti-insulin or anti-insulin receptor antibodies and drugs.

• #58 Hypoglycemia – Wikipedia

  https://en.wikipedia.org/wiki/Hypoglycemia

  Inborn errors of metabolism may cause infant hypoglycemia, and much less commonly adult hypoglycemia. […] A primary B-cell tumor, such as an insulinoma, is associated with hypoglycemia. […] Hypoglycemia may occur in people with non-B cell tumors such as hepatomas, adrenocorticoid carcinomas, and carcinoid tumors. […] The Roux-en-Y gastric bypass has been associated with hypoglycemia, called post-gastric bypass postprandial hypoglycemia. […] Antibodies can be formed against insulin, leading to autoimmune hypoglycemia. […] Low blood sugar may occur in healthy neonates aged less than 48 hours who have not eaten for a few hours.

• #59 Hypoglycemia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/122122-overview

  Fasting hypoglycemia usually diagnosed in infancy or childhood include inherited liver enzyme deficiencies that restrict hepatic glucose release (deficiencies of glucose-6-phosphatase, fructose-1,6-diphosphatase, phosphorylase, pyruvate carboxylase, phosphoenolpyruvate carboxykinase, or glycogen synthetase). […] Several cases of nesidioblastosis were reported recently after gastric bypass surgery.

• #60 Hypoglycemia • LITFL • CCC Differential Diagnosis

  https://litfl.com/hypoglycemia/

  Addisons disease […] Islet cell tumours (e.g. insulinomas) […] Immune hypoglycemia (e.g. anti-insulin receptor antibodies in Hodgkins disease or anti-insulin antibodies that release insulin when insulin levels are relatively low) […] Infection (e.g. severe sepsis, malaria) […] Non-pancreatic neoplasms (e.g fibromas, sarcomas, mesotheliomas, and small cell carcinomas that produce IGF-2; extensive metastases that overwhelm the bodys ability to produce glucose) […] Nesidioblastosis or noninsulinoma pancreatogenous hypoglycemia (NIPH) syndrome (islet cell hyperplasia, which can be congenital or acquired, e.g. post-gastric surgery) […] Starvation and malnutrition […] Hypothyroidism (myxoedema coma).

• #61 Hypoglycemia – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/hypoglycemia

  Hypoglycemia in patients without diabetes is rare. It can occur in the fasting or in the postprandial state (1 to 3 hours after eating) and can be classified as insulin-mediated or non-insulin-mediated. […] Insulin-mediated causes include exogenous insulin, insulin secretagogue (sulfonylurea; eg, glyburide, glipizide, glimepiride) use, insulinoma, post-bariatric surgery hypoglycemia, non-insulinoma pancreatogenous hypoglycemia syndrome (NIPHS), and insulin autoimmune hypoglycemia. […] Non-insulin-mediated causes include adrenal insufficiency and the use of medications other than insulin or a sulfonylurea (eg, quinine, gatifloxicin, pentamidine, alcohol). […] In patients who are ill and hospitalized, spontaneous hypoglycemia that is not caused by medications can occur when poor nutrition is combined with advanced organ failure (especially liver, kidney, or heart failure) and/or sepsis. […] Non-islet cell tumor hypoglycemia is a rare condition caused by production of large amounts of aberrant forms of insulin-like growth factor 2 (IGF-2) by a tumor. […] Factitious hypoglycemia is true hypoglycemia induced by nontherapeutic administration of sulfonylureas or insulin.

• #62 List of causes of hypoglycemia – Wikipedia

  https://en.wikipedia.org/wiki/List_of_causes_of_hypoglycemia

  Hypoglycemia is a common problem with an increasing incidence in critically ill or extremely low birthweight infants. Its potential association with brain damage and neurodevelopment delay make it an important topic. If not due to maternal hyperglycemia, in most cases it is multifactorial, transient and easily supported. In a minority of cases, hypoglycemia turns out to be due to significant hyperinsulinism, hypopituitarism or an inborn error of metabolism and presents more of a management challenge. […] Single episodes of hypoglycemia may occur due to gastroenteritis or fasting, but recurrent episodes nearly always indicate either an inborn error of metabolism, congenital hypopituitarism, or congenital hyperinsulinism. […] By far, the most common cause of severe hypoglycemia in this age range is insulin injected for type 1 diabetes. […] The incidence of hypoglycemia due to complex drug interactions, especially involving oral hypoglycemic agents and insulin for diabetes, rises with age. Though much rarer, the incidence of insulin-producing tumors also rises with advancing age.

• #63 15 Causes of Hypoglycemia (Low Blood Sugar) in Non-Diabetics

  https://www.emedicinehealth.com/what_causes_hypoglycemia_in_nondiabetics/article_em.htm

  Causes of (hypoglycemia) low blood sugar in non-diabetics include some medications, drinking too much alcohol, hypothyroidism, side effects of weight loss surgery, liver or kidney problems, anorexia nervosa, problems in the pancreas, and certain genetic disorders. […] Causes of low blood sugar in non-diabetics includes: […] Some medications […] Drinking too much alcohol […] Hypothyroidism […] Side effects of weight loss surgery […] Liver or kidney problems […] Anorexia nervosa […] Problems in the pancreas […] Certain genetic disorders.

• #64 Ketotic Hypoglycemia: A Guide for Families – Pediatric Endocrine Society

  https://pedsendo.org/patient-resource/ketotic-hypoglycemia-a-guide-for-families/

  Ketotic hypoglycemia is the most common cause of low blood sugar in an otherwise healthy toddler or young child, however a few children may have a more serious condition. […] The cause of ketotic hypoglycemia in most children is unknown. Children with ketotic hypoglycemia have two problems: (1) they tend to use up energy stored in the liver and switch to making ketones for energy sooner than other children, and (2) they are sometimes unable to use stored fat and muscle energy effectively to keep their blood sugar up. These problems usually improve as children get older and become more grown up in the way they store and use fuels like carbohydrate and fat.

• #65 Non-Diabetic Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK573079/

  Hypoglycemia in children will also be briefly reviewed. In children, hypoglycemia is mostly due to inborn errors of metabolism (IEM) and is associated with multisystem involvement. […] There are many causes of non-diabetic hypoglycemia. […] Hypoglycemia caused by drugs is very common. Many drugs other than anti-hyperglycemic medications and alcohol have been reported. […] In children, hypoglycemia is mainly secondary to IEM. It includes glycogen storage disease, fatty acid oxidation defect, ketogenesis defects, and gluconeogenesis disorders. […] Hypoglycemia occurs due to impaired glucose regulation by the liver. […] Hypoglycemia can occur due to corticotropic and somatotropic hormone deficiency. […] The cause of hypoglycemia can be multifactorial and varies with the type of drug. […] Hypoglycemia occurs in the postprandial phase. The mechanism is likely due to an altered rate of digestion and secretion of insulin.

• #66 Hypoglycemia: Clinical Signs, Treatment, Prognosis

  https://preview.cliniciansbrief.com/article/hypoglycemia-0

  Hypoglycemia is a manifestation of a pathologic process not a diagnosis. It is always secondary to a disorder that disrupts or overwhelms one or more of the homeostatic mechanisms responsible for maintenance of normoglycemia. […] Hypoglycemia occurs when the rate of glucose removal exceeds the rate of its addition to blood. Endogenous or exogenous substances that mimic or potentiate insulin action or enhance or accelerate glucose metabolism increase glucose removal, whereas failure of endogenous glucose production decreases the rate of glucose addition to blood. Disruptions of the pathways responsible for glucose addition or removal may overwhelm homeostatic mechanisms and produce clinical hypoglycemia. […] Hypoglycemia has been associated with a variety of clinical conditions but is a consistent feature of relatively few disorders.

• #67 Hypoglycemia: Clinical Signs, Treatment, Prognosis

  https://preview.cliniciansbrief.com/article/hypoglycemia-0

  Clinical disorders produce hypoglycemia through one or more pathophysiologic mechanisms. Clinical hypoglycemia can be broadly divided into several categories: hyperinsulinemic hypoglycemia, hypoinsulinemic hypoglycemia, and miscellaneous disorders. […] Hyperinsulinemic hypoglycemia is the most common mechanism of hypoglycemia in dogs and cats, with relative or absolute insulin excess being a common feature. […] Hypoinsulinemic hypoglycemia describes hypoglycemia that develops independent of insulin; in associated conditions, blood insulin is appropriately low with hypoglycemia. Non-insulin-mediated hypoglycemia may develop via one of several mechanisms. Several tumor types produce humoral insulin-like substances that promote hypoglycemia. […] Hypoglycemia secondary to liver failure subsequent to cirrhosis or other disorders carries a poor prognosis, whereas hypoglycemia in patients with portovascular anomaly is expected to resolve after shunt closure.

• #68 Hypoglycemia: Clinical Signs, Treatment, Prognosis

  https://preview.cliniciansbrief.com/article/hypoglycemia-0

  Clinical disorders produce hypoglycemia through one or more pathophysiologic mechanisms. Clinical hypoglycemia can be broadly divided into several categories: hyperinsulinemic hypoglycemia, hypoinsulinemic hypoglycemia, and miscellaneous disorders. […] Hyperinsulinemic hypoglycemia is the most common mechanism of hypoglycemia in dogs and cats, with relative or absolute insulin excess being a common feature. […] Hypoinsulinemic hypoglycemia describes hypoglycemia that develops independent of insulin; in associated conditions, blood insulin is appropriately low with hypoglycemia. Non-insulin-mediated hypoglycemia may develop via one of several mechanisms. Several tumor types produce humoral insulin-like substances that promote hypoglycemia. […] Hypoglycemia secondary to liver failure subsequent to cirrhosis or other disorders carries a poor prognosis, whereas hypoglycemia in patients with portovascular anomaly is expected to resolve after shunt closure.

• #69 Unexplained Hypoglycemia: A Focused Approach to Finding the Cause | Consultant360

  https://www.consultant360.com/articles/unexplained-hypoglycemia-focused-approach-finding-cause

  Insulinoma is, and remains, an important cause of hypoglycemia, and it should be suspected when the initial workup suggests excessive endogenous insulin production (inappropriately normal or high insulin and C-peptide levels, with low -hydroxybutyrate levels, all in the presence of low serum glucose). […] Other endocrine problems (eg, primary and secondary adrenal insufficiency, hypothyroidism), metabolic problems, and medication errors have become more common.

• #70 Postprandial hypoglycaemia in adults: pathogenesis, diagnosis and management – Sulaiman – Journal of Laboratory and Precision Medicine

  https://jlpm.amegroups.org/article/view/6042/html

  PPH is a well-known late complication of upper gastrointestinal surgery. […] Its exact incidence is unknown; one study reported 9.1% and 7.9% incidence at 1 and 5 years, respectively, post-RYGB surgery. […] A mutation in INSR (insulin receptor kinase) gene leading to impaired insulin clearance and insulin resistance, results in PPH with onset in adolescence to adulthood. […] This disorder develops due to aldolase B deficiency. […] Exogenous hyperinsulinemia causing PPH, due to surreptitious administration of insulin or insulin secretagogues such as sulfonylureas and meglitinides, is usually seen in people who have access to these medications.

• #71 Non-Diabetic Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK573079/

  Hypoglycemia is uncommonly seen in adults without diabetes mellitus. However, all patients should undergo evaluation and management who develop symptoms and/or signs of hypoglycemia (Whipple’s triad), evidence of low blood glucose (55 mg/dL), and resolution of symptoms and/or signs after an increase in blood glucose level. […] Hypoglycemia can be broadly divided into two main groups: Insulin-mediated (hyperinsulinism) and Independent of insulin. […] The endogenous cause of hypoglycemia due to hyperinsulinism in a non-diabetic adult is secondary to Insulinoma and islet cell hyperplasia (nesidioblastosis). […] Insulin independent hypoglycemia includes alcohol, visceral failure (liver/renal failure), critical illness, primary adrenal failure, anterior pituitary failure, severe sepsis, cerebral malaria, anorexia nervosa, glycogen storage disease, post-bariatric surgery, mesenchymal tumors with elevated IGF-2 levels, autoimmune hypoglycemia secondary to anti-insulin or anti-insulin receptor antibodies and drugs.

• #72 Hypoglycemia: Clinical Signs, Treatment, Prognosis

  https://preview.cliniciansbrief.com/article/hypoglycemia-0

  Clinical disorders produce hypoglycemia through one or more pathophysiologic mechanisms. Clinical hypoglycemia can be broadly divided into several categories: hyperinsulinemic hypoglycemia, hypoinsulinemic hypoglycemia, and miscellaneous disorders. […] Hyperinsulinemic hypoglycemia is the most common mechanism of hypoglycemia in dogs and cats, with relative or absolute insulin excess being a common feature. […] Hypoinsulinemic hypoglycemia describes hypoglycemia that develops independent of insulin; in associated conditions, blood insulin is appropriately low with hypoglycemia. Non-insulin-mediated hypoglycemia may develop via one of several mechanisms. Several tumor types produce humoral insulin-like substances that promote hypoglycemia. […] Hypoglycemia secondary to liver failure subsequent to cirrhosis or other disorders carries a poor prognosis, whereas hypoglycemia in patients with portovascular anomaly is expected to resolve after shunt closure.

• #73 Investigation and Causes of Spontaneous (Non-Diabetic) Hypoglycaemia in Adults: Pitfalls to Avoid

  https://www.mdpi.com/2075-4418/13/20/3275

  Although rare, the commonest cause of endogenous hyperinsulinaemic hypoglycaemia is insulinoma, which is characterised by inappropriately high insulin and/or proinsulin, high C-peptide and suppressed or low BOHB in the serum. […] Hypoinsulinaemic (suppressed insulin and c-peptide) hypoglycaemia typically occurs spontaneously or may be provoked by fasting. Causes include tumours, endocrine hormonal deficiencies, organ failure, malnutrition including starvation and IMD. […] Spontaneous hypoinsulinaemic hypoglycaemia may occur in patients with known severe comorbidity, such as advanced liver disease (glycogen depletion and reduced gluconeogenesis), renal failure (reduced gluconeogenesis and reduced insulin clearance), malnutrition and anorexia nervosa (glycogen depletion and reduced gluconeogenesis due to substrate deficiency).

• #74

• #75 Hypoglycemia: Clinical Signs, Treatment, Prognosis

  https://preview.cliniciansbrief.com/article/hypoglycemia-0

  Clinical disorders produce hypoglycemia through one or more pathophysiologic mechanisms. Clinical hypoglycemia can be broadly divided into several categories: hyperinsulinemic hypoglycemia, hypoinsulinemic hypoglycemia, and miscellaneous disorders. […] Hyperinsulinemic hypoglycemia is the most common mechanism of hypoglycemia in dogs and cats, with relative or absolute insulin excess being a common feature. […] Hypoinsulinemic hypoglycemia describes hypoglycemia that develops independent of insulin; in associated conditions, blood insulin is appropriately low with hypoglycemia. Non-insulin-mediated hypoglycemia may develop via one of several mechanisms. Several tumor types produce humoral insulin-like substances that promote hypoglycemia. […] Hypoglycemia secondary to liver failure subsequent to cirrhosis or other disorders carries a poor prognosis, whereas hypoglycemia in patients with portovascular anomaly is expected to resolve after shunt closure.

• #76 Hypoglycemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK534841/

  In patients who do not have diabetes, hypoglycemia is uncommon. Still, when it occurs, there are a few major causes of hypoglycemia: pharmacologic, alcohol, critical illness, counter-regulatory hormone deficiencies, and non-islet cell tumors. […] Most hypoglycemia cases occur in patients with diabetes who are undergoing therapeutic intervention with meglitinides, sulfonylureas, or insulin. Drugs are the most common cause of hypoglycemia. […] Other potential causes of hypoglycemia are critical illness, alcohol, cortisol deficiency, or malnourishment. […] Alcohol inhibits gluconeogenesis in the body but does not affect glycogenolysis. Thus, hypoglycemia occurs after several days of alcohol consumption and after glycogen stores are depleted. […] For example, in critical illness states, end-stage liver disease, sepsis, starvation, or renal failure, glucose utilization exceeds glucose intake, glycogenolysis, or gluconeogenesis. This imbalance can potentially cause hypoglycemia.

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