Endocrine Abstracts

Introduction: Adult factitious hypoglycemia is due to self-administration of insulin or insulin secretagogue, and is the most common cause of Münchhausen syndrome. The objective is to study the epidemiological profile of patients hospitalized for artificial hypoglycemia for better management.

Patients and methods: Retrospective study carried out at the Endocrinology and Metabolic Diseases Department, Ibn Rochd University Hospital - Casablanca, on patients hospitalized from January 2018 to December 2023 for factitious hypoglycemia.

Results: In our study, 16 patients were included, including 4 men and 12 women. Of these, 10 patients (62.5%) were known type 1 diabetics with an average age of 26.1 years (15 years - 35 years) and an average duration of diabetes of 13 years. And 6 patients not known to be diabetic, with an average age of 19.5 years (15 years - 29 years). the 16 patients were admitted to the department with severe hypoglycemia at 0.3 and 0.6 g/l that persisted despite discontinuation of insulin therapy in diabetic patients. all our patients underwent a hormonal work-up with a jeün test. Hormonal assays showed elevated and appropriate cortisol levels in all our patients, with elevated insulin and normal C-peptide levels in 6 patients (3 T1DM and 3 non-diabetic patients), and elevated and inappropriate insulin and C-peptide levels in the other patients. A psychological interview revealed the presence of parental conflicts for our 10 young patients and 6 patients in an anxio-depressive state, with the notion of dummy intake of rapid insulin in 14 patients and dummy intake of gliclazides for 1 non-diabetic patient.

Discussion and conclusion: Factitious hypoglycemia is a difficult-to-diagnose psychiatric disorder. They are most often found in female patients with easy access to hypoglycemic treatments. Psychiatric follow-up is necessary to avoid recurrences, which can be life-threatening in this situation.