Endocrine Abstracts

Introduction

Spontaneous hypoglycemia in non-diabetic adults represent a challenge in confirming the organic cause, requiring in that case specific medication or surgery, in a setting of a possible life-threatening disease.

Methods

We conducted a retrospective study of patients admitted in our department for spontaneous hypoglycemia. Functional and factitious etiology were excluded. Clinical and biologic features were collected and were compared for 2 groups: the patients with confirmed adrenal insufficiency (group 1) and the patients with endogenous hyperinsulinism (group 2).

Results

Fourteen patients were included with confirmed organic hypoglycemia, 4 patients in the group 1 and 10 patients in the group 2. Mean delay between beginning of the symptoms and the day the patient consulted was 7.27 months in the first group and 8 months in the second group. Fasting was impossible in all the cases it was documented. There were 4 women in the group 1 vs 7 women and 3 men in the group 2. The first group had a lower mean age (37 ± 13 years vs 41 ± 15 years), lower body mass index (normal in all patients in group 1, superior to 25 kg/m² in 4 cases over 10 in the second group). Three patients in the first group described a loss of weight, and one with no change, while 6 patients in the second group described a gain of weight and 4 with no change. The group 1 had more neurogenic symptoms than neuroglycopenic ones, while in group 2, all patients had neuroglycopenic symptoms. Group 1 had 3 cases of fasting hypoglycemia and 1 case of late postprandial hypoglycemia, while group 2 had 6 cases of fasting hypoglycemia, 1 case of hypoglycemia after physical activity and 3 cases with no precise moment. Mean glycemia was lower in the second group comparing to the first group (0.27 ± 0.08 g/l vs 0.39 ± 0.13 g/l, P = 0.07).

Conclusion

Our study found differences in gender ratio, age, body mass index, signs and symptoms between the two groups, with lower mean glycemia in the endogenous hyperinsulinism group. A larger study must be conducted to find higher significant results for these clinal parameters.