Endocrine Abstracts

Glucose is the central metabolic currency of life. Severe hypoglycaemia is both symptomatically frightening and life-threatening in the short term. The mechanisms that maintain normal, tight regulation of plasma glucose are thus crucial, and require preserved function of key metabolic and endocrine organs. These can go awry in myriad ways, yet the diagnostic focus of endocrinologists is often surprisingly narrow. This tends to focus on hypoglycaemia caused by insulin administration, hypoglycaemia caused by adrenal, liver or kidney failure, hypoglycaemia caused by neuroendocrine tumours, or the vague entity of postprandial hypoglycaemia. This talk will use a series of cases to illustrate other acquired or congenital causes of hypoglycaemia pertinent to the endocrinologist. These will range from the relatively frequent but under-recognised, to the exquisitely rare but mechanistically informative. The focus will be on combining clinical and biochemical evidence, often in collaboration with laboratory colleagues, in rational diagnostic decision making, and in use of specific diagnoses to guide precision therapy.