A Difficult Diagnostic Problem in Spontaneous Hypoglycemia

Abstract

Case Studies1 December 1964A Difficult Diagnostic Problem in Spontaneous HypoglycemiaReactive Hypoglycemia in Mild Diabetes MellitusMARTIN NYDICK, M.D., ELLIS SAMOLS, M.B., M.R.C.P., TAKESHI KUZUYA, M.D., ROBERT H. WILLIAMS, M.D., F.A.C.P.MARTIN NYDICK, M.D., ELLIS SAMOLS, M.B., M.R.C.P., TAKESHI KUZUYA, M.D., ROBERT H. WILLIAMS, M.D., F.A.C.P.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-6-1122 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn patients with hypoglycemia, the etiologic diagnosis depends on an interpretation of the response of the blood sugar to various provocative tests, usually including the administration of glucose, tolbutamide, L-leucine, and a prolonged fast. Plasma insulin assay appears to improve diagnostic accuracy, although the importance of its contribution can only be assessed after extensive experience. The following report of a difficult differential diagnostic problem is of particular interest as it represents the first description of the behavior of serum insulin in a patient with diabetes mellitus and reactive hypoglycemia; and in addition, some of the data bear on the question...References1. SELTZERFAJANSCONN HSSSJW: Spontaneous hypoglycemia as an early manifestation of diabetes mellitus. Diabetes 5: 437, 1956. CrossrefMedlineGoogle Scholar2. YALOWBERSON RSSA: Immunoassay of endogenous plasma insulin in man. J. Clin. Invest. 39: 1157, 1960. CrossrefMedlineGoogle Scholar3. FRIEDBERGSHERBOGDONOFFESTES SJPBMDEH: The dynamics of free fatty acid metabolism during exercise. J. Lipid Res. 4: 34, 1963 CrossrefMedlineGoogle Scholar4. CONNSELTZER JWHS: Spontaneous hypoglycemia. Amer. J. Med. 19: 460, 1955. CrossrefMedlineGoogle Scholar5. UNGERMADISON RHLL: A new diagnostic procedure for mild diabetes mellitus. Diabetes 7: 455, 1958. CrossrefMedlineGoogle Scholar6. 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RANDLEGARLANDHALESNEWSHOLME PJPBCNEA: The glucose fatty-acid cycle: its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus. Lancet 1: 785, 1963. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Seattle, WashingtonFrom the Department of Medicine, University of Washington, Seattle, Wash.This work was supported in part by grants AM-02456 and T1-AM-5020 from the National Institute of Arthritis and Metabolic Diseases, U. S. Public Health Service, Bethesda, Md., and grant FR-37 of the National Institutes of Health, U. S. Public Health Service, Bethesda, Md.Requests for reprints should be addressed to Robert H. Williams, M.D., Department of Medicine, University of Washington, Seattle 5, Wash.*The authors would like to thank Dr. John H. Lehmann of Seattle, Washington for allowing the study of his patient. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHypoglycemia, Malnutrition and Body CompositionSpontanhypoglykämienSteps in the Diagnosis of Three Functioning Endocrine TumorsDie spontanen HypoglykämienSerum Immunoreactive Insulin in Clinical PracticeNewer Considerations in the Diagnosis and Management of Fasting HypoglycemiaGlucagon test for insulinoma: a chemical study in 25 casesThe Diagnosis of InsulomaGlycosuriaFunctional Hypoglycemia and Peptic UlcerThe Natural History of Idiopathic Hypoglycemia of Infancy and Its Relation to Diabetes Mellitus 1 December 1964Volume 61, Issue 6Page: 1122-1127KeywordsDiabetes mellitusDiagnostic medicineGlucoseHypoglycemiaInsulinInsulinomaLeucineMedical servicesMetabolic disordersPrevention, policy, and public health Issue Published: 1 December 1964 PDF downloadLoading ...