ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 EP5 | DOI: 10.1530/endoabs.63.EP5

Low blood glucose, but why?

Loubna Oukit, Sana Rafi, Ghizlane El Mghari & Nawal El Ansari

Department Endocrinology, CHU Mohamed VI, Marrakesh, Morocco.

Introduction: Hypoglycaemia in non diabetic patients is a decrease of blood glucose below a threshold of 0.5 g/l, corresponds to a pathological situation, with many etiologies and whose management constitutes a real challenge, both symptomatic and etiological. The purpose of this study is to highlight the profile of these hypoglycaemia and their management.

Patients and method: We have collected cases of hypoglycaemia in non-diabetic subjects encountered in the endocrinology department over the past three years.

Results: We collected eight cases. The average age of these patients was 47.5 years, with a female predominance. The mode of revelation was unconsciousness in four cases, convulsions in one case, and hypoglycemic discomfort in three cases. The etiologies were insulinomas in 6 cases, one in the setting of MEN1 (with hyperparathyroidism and macroprolactinoma). One patient had a mesenchymal tumor of the chest wall secreting IGF2, and a fictitious hypoglycemia in a young depressive patient living in a family-conflict setting. The investigations included hormonemia in 6 cases: average insulinemia was 69 μU/ml (23 times the normal level) and the average peptide C at 1.37 pmol/ml (2.2 times the normal level). The topographic assessment included an octreotide scintigraphy in 7 cases, positive in 4 cases. The treatment was surgical in the case of insulinomas and mesenchymal tumor. The pathological anatomy was conclusive in 3 cases. The evolution was marked by a regression of the hypoglycemias, a decrease of their frequency and their depth. And after 24 hours of monitoring, no hypoglycemia was noted in the factitious intake of insulin.

Discussion: Hypoglycemic discomfort is always a hardship for the patient and a challenge for the practitioner. In the organic hypoglycemia, we can improve the quality of life and avoid complications of the patient by finding an etiology, as it is frequently curable.

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