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.
18 - 21 May 2019
European Society of Endocrinology