Hypoglycemia - Knowledge

1702:, the prevention of hypoglycemia has a large focus on patient education and medication adjustments. The foundation of diabetes education is learning how to recognize the signs and symptoms of hypoglycemia, as well as learning how to act quickly to prevent worsening of an episode. Another cornerstone of prevention is strong self-monitoring of blood glucose, with consistent and frequent measurements. Research has shown that patients with type 1 diabetes who use 1678: 1188:, may cause hypoglycemia. Normally, breakdown of glycogen leads to increased glucose levels, particularly in a fasting state. In glycogen storage diseases, however, glycogen cannot be properly broken down, leading to inappropriately decreased glucose levels in a fasting state, and thus hypoglycemia. The glycogen storage diseases associated with hypoglycemia include 62: 1894:

a too large a dose of insulin, the rabbits began convulsing, went into a coma, and then died. This observation simplified his assay. He defined one unit of insulin as the amount necessary to induce this convulsing hypoglycemic reaction in a rabbit. Collip later found he could save money, and rabbits, by injecting them with glucose once they were convulsing.

1096:, which is a psychiatric disorder. Demographics affected by factitious hypoglycemia include women aged 30–40, particularly those with diabetes, relatives with diabetes, healthcare workers, or those with history of a psychiatric disorder. The classic way to identify surreptitious insulin use is through blood work revealing high insulin levels with low 3011: 1583: 1337:. In autoimmune hypoglycemia, there are two possible mechanisms. In one instance, antibodies bind to insulin following its release associated with a meal, resulting in insulin being non-functional. At a later time, the antibodies fall off insulin, causing insulin to be functional again leading late hypoglycemia after a meal, called 1413:, who demonstrate Whipple's triad, it is reasonable to assume the cause of hypoglycemia is due to insulin, glinides, or sulfonylurea use. In those without a history of diabetes with hypoglycemia, further diagnostic testing is necessary to identify the cause. Testing, during an episode of hypoglycemia, should include the following: 1552:. This same review reported that, based on limited evidence, no difference was found in plasma glucose when administering combined oral and buccal glucose (via dextrose gel) compared to only oral administration. The second best way to consume a carbohydrate it to allow it to dissolve under the tongue, also referred to as 1661:

was approved for medical use in the United States in March 2021, to treat severe hypoglycemia. Dasiglucagon (brand name Zegalogue) is unique because it is glucagon in a prefilled syringe or auto-injector pen, as opposed to traditional glucagon kits that require mixing powdered glucagon with a liquid.

1612:

kit may be used to treat severe hypoglycemia, which delivers glucagon either by injection into a muscle or through nasal inhalation. In the United States, glucacon kits are available by prescription for diabetic patients to carry in case of an episode of severe hypoglycemia. Emergency services should

1570:

Family, friends, and co-workers of a person with diabetes may provide life-saving treatment in the case of a hypoglycemic episode It is important for these people to receive training on how to recognize hypoglycemia, what foods to help the hypoglycemic eat, how to administer injectable or intra-nasal

1492:

After hypoglycemia in a person is identified, rapid treatment is necessary and can be life-saving. The main goal of treatment is to raise blood glucose back to normal levels, which is done through various ways of administering glucose, depending on the severity of the hypoglycemia, what is on-hand to

984:

are also sites of glucose production, their failure of glucose production is not significant enough to cause hypoglycemia. Instead, the kidneys are responsible for removing insulin from the body, and when this function is impaired in kidney failure, the insulin stays in circulation longer, leading to

857:. This is often due to excessive doses or poorly timed doses. Sometimes diabetics may take insulin in anticipation of a meal or snack; then forgetting or missing eating that meal or snack can lead to hypoglycemia. This is due to increased insulin without the presence of glucose from the planned meal. 431:

In children who are aged greater than 48 hours, serum glucose on average ranges from 70 to 100 mg/dL (3.9–5.5 mmol/L), similar to adults. Elderly patients and patients who take diabetes pills such as sulfonylureas are more likely to suffer from a severe hypoglycemic episode. Whipple's triad

418:

The biggest difference in blood glucose levels between the adult and pediatric population occurs in newborns during the first 48 hours of life. After the first 48 hours of life, the Pediatric Endocrine Society cites that there is little difference in blood glucose level and the use of glucose between

1893:

on purifying insulin in 1922. Collip was asked to develop an assay to measure the activity of insulin. He first injected insulin into a rabbit, and then measured the reduction in blood-glucose levels. Measuring blood glucose was a time-consuming step. Collip observed that if he injected rabbits with

877:

hypoglycemic unawareness experience the symptoms of hypoglycemia at far lower levels of blood glucose. This is dangerous for a number of reasons. The hypoglycemic person not only gains awareness of hypoglycemia at very low blood glucose levels, but they also require high levels of carbohydrates or

641:

Everyone experiences different symptoms of hypoglycemia, so someone with hypoglycemia may not have all of the symptoms listed above. Symptoms also tend to have quick onset. It is important to quickly obtain a blood glucose measurement in someone presenting with symptoms of hypoglycemia to properly

427:

levels following birth, which may cause temporary hypoglycemia. As a result, there has been difficulty in developing guidelines on interpretation and treatment of low blood glucose in neonates aged less than 48 hours. Following a data review, the Pediatric Endocrine Society concluded that neonates

1536:

Improvement in blood sugar levels and symptoms are expected to occur in 15–20 minutes, at which point blood sugar should be measured again. If the repeat blood sugar level is not above 70 mg/dL (3.9 mmol/L), consume another 10–20 grams of a carbohydrate and remeasure blood sugar levels

376:

Blood-sugar levels naturally fluctuate throughout the day, the body normally maintaining levels between 70 and 110 mg/dL (3.9–6.1 mmol/L). Although 70 mg/dL (3.9 mmol/L) is the lower limit of normal glucose, symptoms of hypoglycemia usually do not occur until blood sugar has

1604:

to raise blood glucose levels to a minimum of 70 mg/dL (3.9 mmol/L). Improvement in blood sugar level and symptoms is expected to occur in 15–20 minutes, at which point blood sugar is measured again. If the repeat blood sugar level is not above 70 mg/dL (3.9 mmol/L), the

1714:

can sound alarms when blood glucose is too low or too high, especially helping those with nocturnal hypoglycemia or hypoglycemic unawareness. In terms of medication adjustments, medication doses and timing can be adjusted to prevent hypoglycemia, or a medication can be stopped altogether.

91:

Headache, blurred vision, shakiness, dizziness, weakness, tiredness, sweating, clamminess, fast heart rate, pounding heartbeat, nervousness or anxiety, hunger, nausea, pins and needles sensation, difficulty talking, confusion, unusual behavior, lightheadedness, pale skin color,

778:, while also preventing the use of glucose by other organs. The effects of cortisol and growth hormone are far less effective than epinephrine. In a state of hypoglycemia, the brain also signals a sense of hunger and drives the person to eat, in an attempt to increase glucose. 1600:. If blood glucose is below 70 mg/dL (3.9 mmol/L), treatment will depend on whether the person is conscious and can swallow safely. If the person is conscious and able to swallow, the family, friend, or co-worker can help the hypoglycemic consume 10–20 grams of a 1465:, in which a patient undergoes an observed fast to cause a hypoglycemic episode, allowing for appropriate blood work to be drawn. In some, the hypoglycemic episode may be reproduced simply after a mixed meal, whereas in others a fast may last up to 72 hours. 428:

aged less than 48 hours begin to respond to hypoglycemia at serum glucose levels of 55–65 mg/dL (3.0–3.6 mmol/L). This is contrasted by the value in adults, children, and older infants, which is approximately 80–85 mg/dL (4.4–4.7 mmol/L).

1369:

levels following birth, which may trigger transient hypoglycemia. In children who are aged greater than 48 hours, serum glucose on average ranges from 70 to 100 mg/dL (3.9–5.5 mmol/L), similar to adults, with hypoglycemia being far less common.

1595:

Family, friends, and co-workers of those with hypoglycemia are often first to identify hypoglycemic episodes, and may offer help. Upon recognizing the signs and symptoms of hypoglycemia in a diabetic, a blood sugar level should first be measured using a

353:

can also be adjusted or stopped to prevent hypoglycemia. Frequent and routine blood glucose testing is recommended. Some may find continuous glucose monitors with insulin pumps to be helpful in the management of diabetes and prevention of hypoglycemia.

247:

is used to properly identify hypoglycemic episodes. It is defined as blood glucose below 70 mg/dL (3.9 mmol/L), symptoms associated with hypoglycemia, and resolution of symptoms when blood sugar returns to normal. Hypoglycemia may result in

1605:

hypoglycemic should consume another 10–20 grams of a carbohydrate and with remeasurement of blood sugar levels after 15–20 minutes. Repeat until blood glucose levels have returned to normal levels, or call emergency services for further assistance.

4229:"HIGHLIGHTS OF PRESCRIBING INFORMATION. These highlights do not include all the information needed to use ZEGALOGUE® safely and effectively. See full prescribing information for ZEGALOGUE. ZEGALOGUE (dasiglucagon) injection, for subcutaneous use" 4647: 4628: 4597: 1112:

The production of glucose is blocked by alcohol. In those who misuse alcohol, hypoglycemia may be brought on by a several-day alcohol binge associated with little to no food intake. The cause of hypoglycemia is multifactorial, where

1537:

after 15–20 minutes. Repeat until blood glucose levels have returned to normal levels. The greatest improvements in blood glucose will be seen if the carbohydrate is chewed or drunk, and then swallowed. This results in the greatest

1255:, which in turn decreases glucose levels, causing hypoglycemia. Normal regulatory mechanisms are not in place, which prevent insulin levels from falling during states of low blood glucose. During an episode of hypoglycemia, plasma 881:

While the exact cause of hypoglycemic unawareness is still under research, it is thought that these individuals progressively begin to develop fewer adrenergic-type symptoms, resulting in the loss of neuroglycopenic-type symptoms.

4791: 3690:

NIH Intramural Sequencing Center Group, Sloan JL, Johnston JJ, Manoli I, Chandler RJ, Krause C, Carrillo-Carrasco N, Chandrasekaran SD, Sysol JR, O'Brien K, Hauser NS, Sapp JC, Dorward HM, Huizing M, Barshop BA (2011).

385:

The symptoms of low blood sugar alone are not specific enough to characterize a hypoglycemic episode. A single blood sugar reading below 70 mg/dL is also not specific enough to characterize a hypoglycemic episode.

3085: 2863: 869:, or the decreased ability to recognize hypoglycemia. As diabetics experience more episodes of hypoglycemia, the blood glucose level which triggers symptoms of hypoglycemia decreases. In other words, people 953:, a common cause of hypoglycemia in serious illness, can lead to hypoglycemia through many ways. In a state of sepsis, the body uses large amounts of glucose for energy. Glucose use is further increased by 1543:

of glucose, meaning the greatest amount of glucose enters the body producing the best possible improvements in blood glucose levels. A 2019 systematic review suggests, based on very limited evidence, that

334:

and able to swallow. The goal is to consume 10–20 grams of a carbohydrate to raise blood glucose levels to a minimum of 70 mg/dL (3.9 mmol/L). If a person is not able to take food by mouth,

4784: 673:

is another hormone involved in regulating blood glucose levels, and can be thought of as the opposite of insulin. Glucagon helps to increase blood glucose levels, especially in states of hunger.

1767:

to also lessen hypoglycemic episodes. Post-gastric bypass hypoglycemia can be prevented by eating smaller, more frequent meals, avoiding sugar-filled foods, as well as medical treatment with an

1739:

can be prevented with appropriate hormone replacement. The hypoglycemic episodes associated with non-B cell tumors can be decreased following surgical removal of the tumor, as well as following

4265: 5006: 377:

fallen to 55 mg/dL (3.0 mmol/L) or lower. The blood-glucose level at which symptoms of hypoglycemia develop in someone with several prior episodes of hypoglycemia may be even lower.

2032: 4461: 2705: 4777: 943:

Serious illness may result in low blood sugar. Severe disease of many organ systems can cause hypoglycemia as a secondary problem. Hypoglycemia is especially common in those in the

1386:

are a blood sugar level below 70 mg/dL (3.9 mmol/L), symptoms related to low blood sugar, and improvement of symptoms when blood sugar is restored to normal. Identifying

1723:

In those with hypoglycemia who do not have diabetes, there are a number of preventative measures dependent on the cause. Hypoglycemia caused by hormonal dysfunction like lack of

1559:

For example, a hard candy can be dissolved under the tongue, however the best improvements in blood glucose will occur if the hard candy is chewed and crushed, then swallowed.

1509:

If an individual recognizes the symptoms of hypoglycemia coming on, blood sugar should promptly be measured, and a sugary food or drink should be consumed. The person must be

3412:

Lucidi P, Porcellati F, Bolli GB, Fanelli CG (August 2018). "Prevention and Management of Severe Hypoglycemia and Hypoglycemia Unawareness: Incorporating Sensor Technology".

2855: 1907: 653:

is the main source of energy for the brain, and a number of mechanisms are in place to prevent hypoglycemia and protect energy supply to the brain. The body can adjust

2918: 1056:

If a person without diabetes accidentally takes medications that are traditionally used to treat diabetes, this may also cause hypoglycemia. These medications include

2578: 4999: 1669:

has been used for hypoglycemia in the United Kingdom, but it has recently replaced much of its glucose with artificial sweeteners, which do not treat hypoglycemia.

3464:

Murad MH, Coto-Yglesias F, Wang AT, Sheidaee N, Mullan RJ, Elamin MB, et al. (March 2009). "Clinical review: Drug-induced hypoglycemia: a systematic review".

1349:. The antibodies attach to insulin receptors and prevent insulin breakdown, or degradation, leading to inappropriately high insulin levels and low glucose levels. 973:

are sites of glucose production, and in a state of sepsis those organs may not receive enough oxygen, leading to decreased glucose production due to organ damage.

3003: 2666: 2600: 2938:"Glucose Control, Sulfonylureas, and Insulin Treatment in Elderly People With Type 2 Diabetes and Risk of Severe Hypoglycemia and Death: An Observational Study" 1220: 4498: 890:

are caused by the body's reaction to low glucose in the brain, and can result in fast heart rate, sweating, nervousness, and hunger. See section above on

4992: 4239: 1513:

and able to swallow. The goal is to consume 10–20 grams of a carbohydrate to raise blood glucose levels to a minimum of 70 mg/dL (3.9 mmol/L).

4275: 330:

Hypoglycemia is treated by eating a sugary food or drink, for example glucose tablets or gel, apple juice, soft drink, or lollies. The person must be

5563: 3033: 2024: 1858: 1018: 1786:

which often require surgical removal of the tumor for hypoglycemia to remit. In patients who cannot undergo surgery for removal of the insulinoma,

1310:. Although the entire mechanism of hypoglycemia following this surgery is not fully understood, it is thought that meals cause very high levels of 2808:"Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children" 1395: 4453: 4068:

De Buck E, Borra V, Carlson JN, Zideman DA, Singletary EM, Djärv T, et al. (Cochrane Metabolic and Endocrine Disorders Group) (April 2019).

1121:. Glycogen stores are then unable to be repleted due to the lack of food intake, all compounded the inhibition of glucose production by alcohol. 167:: Symptoms of hypoglycemia, serum blood glucose level <70 mg/dL (3.9 mmol/L), and resolution of symptoms when blood glucose returns to normal 2697: 2644: 1710:

significantly improve blood glucose control. Insulin pumps help to prevent high glucose spikes, and help prevent inappropriate insulin dosing.

1625:

access. If a patient is conscious and able to swallow safely, food or drink may be administered, as well as glucose tabs or gel. In those with

993:

A number of medications have been identified which may cause hypoglycemia, through a variety of ways. Moderate quality evidence implicates the

3878: 3240:

Johnson-Rabbett B, Seaquist ER (September 2019). "Hypoglycemia in diabetes: The dark side of diabetes treatment. A patient-centered review".

2630: 2564: 1333:

are immune cells produced by the body, that normally attack bacteria and viruses, but sometimes can attack normal human cells, leading to an

886:

are caused by low glucose in the brain, and can result in tiredness, confusion, difficulty with speech, seizures, and loss of consciousness.

4839: 980:

is the main site of glucose production in the body, and any liver failure or damage will lead to decreased glucose production. While the

5573: 5304: 994: 4864: 493:

Hypoglycemic symptoms are divided into two main categories. The first category is symptoms caused by low glucose in the brain, called

3058: 338:

by injection or insufflation may help. The treatment of hypoglycemia unrelated to diabetes includes treating the underlying problem.

1197: 1501:, followed by a 15-minute wait and re-measurement of blood glucose level to assess if blood glucose has returned to normal levels. 1461:

If necessary, a diagnostic hypoglycemic episode can be produced in an inpatient or outpatient setting. This is called a diagnostic

4407:

Mian Z, Hermayer KL, Jenkins A (November 2019). "Continuous Glucose Monitoring: Review of an Innovation in Diabetes Management".

1201: 878:

glucagon to recover their blood glucose to normal levels. These individuals are also at far greater risk of severe hypoglycemia.

804:. Hypoglycemia is rare in those without diabetes, because there are many regulatory mechanisms in place to appropriately balance 873:

hypoglycemic unawareness experience symptoms of hypoglycemia at a blood glucose of about 55 mg/dL (3.0 mmol/L). Those

3987: 1193: 1189: 1022: 341:

Among people with diabetes, prevention starts with learning the signs and symptoms of hypoglycemia. Diabetes medications, like

4947: 1862: 1216: 787: 4557: 3567: 3523: 3213: 3174: 727:

Once blood glucose levels fall out of the normal range, additional protective mechanisms work to prevent hypoglycemia. The

5505: 5261: 4963: 2693: 1494: 1034: 1782:

Some causes of hypoglycemia require treatment of the underlying cause to best prevent hypoglycemia. This is the case for

5568: 1288: 476: 327:, and several medications. Low blood sugar may occur in otherwise healthy newborns who have not eaten for a few hours. 5197: 5159: 4805: 1854: 1768: 1160: 324: 202:

In type 1 diabetics, mild hypoglycemia occurs twice per week on average, and severe hypoglycemia occurs once per year.

3801:"Combined malonic and methylmalonic aciduria due to ACSF3 mutations: Benign clinical course in an unselected cohort" 1562:

After correcting blood glucose levels, people may consume a full meal within one hour to replenish glycogen stores.

1361:

aged less than 48 hours who have not eaten for a few hours. During the 48-hour neonatal period, the neonate adjusts

5538: 4940: 3893: 1711: 1703: 1481: 676:

When blood sugar levels fall to the low-normal range, the first line of defense against hypoglycemia is decreasing

5089: 5366: 1554: 1306: 1151:, is another cause of hypoglycemia in children, particularly with long periods of fasting or increased exercise. 5239: 4686: 4506: 4155: 3063: 1645:

While the treatment of hypoglycemia is typically managed with carbohydrate consumption, glucagon injection, or

1442: 1183: 497:

symptoms. The second category of symptoms is caused by the body's reaction to low glucose in the brain, called

4228: 2734:"Causative anti-diabetic drugs and the underlying clinical factors for hypoglycemia in patients with diabetes" 1080:

When individuals take insulin without needing it, to purposefully induce hypoglycemia, this is referred to as

3750:"The emerging role of the mitochondrial fatty-acid synthase (mtFASII) in the regulation of energy metabolism" 2227:"Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline" 739:

that increases glucose production by the liver and kidneys, and increases muscle and fat breakdown to supply

5234: 5102: 5067: 4125: 1630: 1342: 1311: 923:

Drinking alcohol, especially when combined with diabetic medications, as alcohol inhibits glucose production

97: 4186:"An inpatient hypoglycemia committee: development, successful implementation, and impact on patient safety" 5500: 5354: 5192: 5154: 1300: 1228: 976:

Other causes of serious illness that may cause hypoglycemia include liver failure and kidney failure. The

455: 445: 5294: 5271: 5256: 5187: 4562: 1609: 1549: 1179:. Inborn errors of metabolism may cause infant hypoglycemia, and much less commonly adult hypoglycemia. 1068:. This may occur through medical errors in a healthcare setting or through pharmacy errors, also called 704:

can be thought of as the inactive, storage form of glucose. Decreased insulin also allows for increased

335: 269: 192: 102: 1303:, is a weight-loss surgery performed on the stomach, and has been associated with hypoglycemia, called 3796: 1029:(also called beta blockers). Other medications with very low quality evidence include the antibiotics 5492: 5349: 5337: 5314: 5169: 5037: 4834: 4353:"A systematic review on clinical implication of continuous glucose monitoring in diabetes management" 1866: 1811: 1728: 1691: 1634: 1402: 1130: 1057: 1006: 846: 825: 809: 793: 342: 284: 2856:"FDA approves first treatment for severe hypoglycemia that can be administered without an injection" 392:

is a set of three conditions that need to be met to accurately characterize a hypoglycemic episode.

5330: 5325: 5222: 5062: 4651: 4270: 1626: 1622: 1545: 1093: 944: 280: 124: 3004:"Hypoglycemia in adults without diabetes mellitus: Clinical manifestations, diagnosis, and causes" 1822:. It is estimated that type 1 diabetics experience two mild, symptomatic episodes of hypoglycemia 1677: 961:

are a protein produced by the body in a state of stress, particularly when fighting an infection.

5047: 4930: 4801: 4769: 4432: 3961: 3836: 3777: 3749: 3595: 3437: 3328: 3297: 3265: 3200:. In Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, et al. (eds.). 2837: 2806:

Thornton PS, Stanley CA, De Leon DD, Harris D, Haymond MW, Hussain K, et al. (August 2015).

2660: 2594: 1877:. Insulin use remains a key risk factor in developing hypoglycemia, regardless of diabetes type. 1334: 1224: 845:

The most common cause of hypoglycemia in diabetics is medications used to treat diabetes such as

409:

The signs and symptoms of hypoglycemia resolve after blood glucose levels have returned to normal

86: 4909: 4528: 1629:

access, 25 grams of 50% dextrose is commonly administered. When there is no intravenous access,

1387: 1383: 1379: 743:. If increased glucagon does not raise blood sugar levels to normal, the adrenal glands release 388: 244: 164: 2225:

Cryer PE, Axelrod L, Grossman AB, Heller SR, Montori VM, Seaquist ER, Service FJ (March 2009).

406:

A low blood glucose measurement is present, typically less than 70 mg/dL (3.9 mmol/L)

295:. Risk is greater in diabetics who have eaten less than usual, recently exercised, or consumed 5432: 5411: 5079: 5074: 4870: 4813: 4726: 4697: 4622: 4424: 4384: 4328: 4207: 4099: 4047: 3953: 3874: 3828: 3820: 3769: 3730: 3712: 3672: 3654: 3615: 3559: 3515: 3481: 3429: 3394: 3320: 3257: 3205: 3166: 3093: 2965: 2957: 2894: 2829: 2765: 2636: 2626: 2570: 2560: 2248: 1890: 1850: 1740: 1417: 484:

Lab or blood draw error (lack of antiglycolytic agent in collection tube or during processing)

159: 74: 4618: 4614: 4610: 4606: 3693:"Exome sequencing identifies ACSF3 as a cause of combined malonic and methylmalonic aciduria" 759:, while also decreasing the use of glucose by organs, protecting the brain's glucose supply. 5522: 5179: 4897: 4416: 4374: 4364: 4318: 4310: 4197: 4089: 4081: 4037: 4029: 3943: 3866: 3812: 3761: 3748:

Wehbe Z, Behringer S, Alatibi K, Watkins D, Rosenblatt D, Spiekerkoetter U, Tucci S (2019).

3720: 3704: 3662: 3646: 3607: 3473: 3421: 3384: 3374: 3312: 3249: 2949: 2819: 2755: 2745: 2238: 1212: 1205: 1164: 1010: 468: 220: 3799:, Clarke JT, Laframboise R, Maranda B, Mitchell GA, Brunel-Guitton C, Braverman NE (2019). 3296:

Ibrahim M, Baker J, Cahn A, Eckel RH, El Sayed NA, Fischl AH, et al. (November 2020).

1865:

inhibitors, do not cause hypoglycemia. Hypoglycemia is common in type 2 diabetics who take

1088:. Some people may use insulin to induce weight loss, whereas for others this may be due to 5515: 5510: 4935: 4829: 4824: 3635:"Diagnosis and Clinical Management of Long-chain Fatty-acid Oxidation Disorders: A Review" 1842: 1838: 1807: 1803: 1752: 1736: 1539: 1144: 965:

may inhibit glucose production, further decreasing the body's energy stores. Finally, the

771: 752: 740: 717: 705: 557: 544: 494: 463: 440:

Other conditions that may present at the same time as hypoglycemia include the following:

257: 232: 3800: 897:

In terms of epidemiology, hypoglycemic unawareness occurs in 20–40% of type 1 diabetics.

3858: 920:

Exercising more than usual as it leads to more use of glucose, especially by the muscles

5423: 5279: 5052: 5042: 4379: 4352: 4323: 4298: 4202: 4185: 4094: 4069: 4042: 4017: 3725: 3692: 3667: 3634: 3389: 3362: 2760: 2733: 1918: 1831: 1826:

Additionally, people with type 1 diabetes have at least one severe hypoglyemic episode

1760: 1756: 1732: 1690:

The prevention of hypoglycemia depends on the cause. In those with diabetes treated by

1314:(also called GLP-1), a hormone that increases insulin, causing glucose levels to drop. 1148: 1050: 926: 775: 767: 756: 693: 689: 669:. Insulin helps to regulate the amount of glucose in the body, especially after meals. 522: 304: 296: 144: 4680: 4676: 4672: 4668: 4664: 4660: 4656: 5557: 5466: 5445: 5359: 5284: 5217: 4892: 4883: 4436: 3781: 3332: 3269: 1597: 1576: 1510: 1421: 1341:. Another mechanism causing hypoglycemia is due to antibodies formed against insulin 308: 152: 79: 33: 4984: 4737: 3979: 3965: 3840: 3441: 2841: 1137:. Addison's disease is associated with chronically low levels of the stress hormone 5471: 5343: 5244: 5032: 4314: 4085: 4033: 1886: 1874: 1819: 1744: 1707: 1699: 1658: 1601: 1498: 1410: 1391: 1326: 1172: 1069: 1065: 1042: 1038: 1030: 1026: 1014: 850: 801: 721: 613: 588: 581: 346: 288: 176: 136: 4297:

Langendam M, Luijf YM, Hooft L, Devries JH, Mudde AH, Scholten RJ (January 2012).

1548:

of glucose leads to a bigger improvement in blood glucose levels when compared to

1287:

tumors. These tumors lead to a state of increased insulin, specifically increased

4691: 4016:

De Buck E, Borra V, Carlson JN, Zideman DA, Singletary EM, Djärv T (April 2019).

3870: 3857:

Ozand PT, Al-Essa M (2012), Elzouki AY, Harfi HA, Nazer HM, Stapleton FB (eds.),

3765: 1523:

Juice containing sugar like apple, grape, or cranberry juice, 4 ounces or 1/2 cup

432:

is used to identify hypoglycemia in children who can communicate their symptoms.

5289: 5249: 5229: 5164: 5126: 5117: 5112: 5107: 5024: 4721: 4420: 3948: 3931: 2886: 2824: 2807: 2732:

Yanai H, Adachi H, Katsuyama H, Moriyama S, Hamasaki H, Sako A (February 2015).

1870: 1815: 1695: 1406: 1089: 1061: 998: 623: 574: 265: 240: 4746: 4743: 4740: 3551: 3507: 3197: 3158: 947:

or those in whom food and drink is withheld as a part of their treatment plan.

5209: 5149: 5136: 5057: 5016: 4968: 4752: 4702: 4641: 4637: 4266:"Diabetic patients should be warned about changes to Lucozade glucose content" 3650: 3425: 3363:"Mechanisms of hypoglycemia unawareness and implications in diabetic patients" 2574: 1791: 1783: 1776: 1764: 1654: 1473: 1469: 1436: 1366: 1264: 1244: 1176: 1118: 1101: 748: 744: 661:, and adjust glucose use by the body. The body naturally produces the hormone 498: 450: 424: 320: 183: 3824: 3716: 3658: 3097: 2961: 2640: 1497:

is the "15-15 Rule," which suggests consuming or administering 15 grams of a

894:

for further explanation of neuroglycopenic symptoms and adrenergic symptoms.

419:

adults and children. During the 48-hour neonatal period, the neonate adjusts

17: 5381: 5376: 5371: 5299: 5097: 4973: 4757: 4732: 4568: 3253: 2937: 2936:

Ling S, Zaccardi F, Lawson C, Seidu SI, Davies MJ, Khunti K (1 April 2021).

1846: 1787: 1772: 1650: 1649:

administration, there are some other treatments available. Medications like

1430: 1378:

The most reliable method of identifying hypoglycemia is through identifying

1284: 1260: 1097: 854: 539: 350: 331: 292: 253: 4428: 4388: 4369: 4332: 4211: 4103: 4051: 3957: 3832: 3773: 3734: 3676: 3619: 3596:"Hypoglycemia in association with various organic and amino acid disorders" 3563: 3519: 3485: 3433: 3398: 3324: 3261: 3209: 3170: 2969: 2898: 2833: 2769: 2554: 2252: 1621:

In a healthcare setting, treatment depends on the severity of symptoms and

3754:

Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids

3379: 2620: 2023:

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

1493:

treat, and who is administering the treatment. A general rule used by the

1219:, can lead to the symptom of intermittent hypoglycemia, as for example in 61: 5461: 5393: 5144: 3930:

Lupsa BC, Chong AY, Cochran EK, Soos MA, Semple RK, Gorden P (May 2009).

3611: 3477: 2750: 2553:

Jameson JL, Kasper DL, Longo DL, Fauci AS, Hauser SL, Loscalzo J (2018).

2243: 2226: 1748: 1724: 1666: 1646: 1572: 1455: 1362: 1330: 1322: 1280: 1276: 1248: 1240: 1138: 1114: 962: 958: 954: 829: 813: 797: 763: 732: 728: 701: 697: 681: 670: 666: 517: 420: 399:

The signs and symptoms of hypoglycemia are present (see section below on

261: 249: 243:

to levels below normal, typically below 70 mg/dL (3.9 mmol/L).

5401: 4921: 4070:"First aid glucose administration routes for symptomatic hypoglycaemia" 4018:"First aid glucose administration routes for symptomatic hypoglycaemia" 3816: 3086:"If you've ever been hangry, this is what your body may be telling you" 1477: 1462: 1256: 1252: 1168: 1134: 1046: 1002: 914: 910: 821: 805: 736: 677: 662: 654: 650: 603: 552: 529: 312: 273: 188: 132: 128: 4589: 3316: 2953: 5406: 4857: 4854: 4851: 4848: 4845: 4842: 4632: 4601: 1358: 981: 970: 950: 713: 618: 596: 300: 140: 4299:"Continuous glucose monitoring systems for type 1 diabetes mellitus" 4147: 3865:, Berlin, Heidelberg: Springer Berlin Heidelberg, pp. 451–514, 2625:. William A. Kormos, Davoren A. Chick (6th ed.). Philadelphia. 1582: 3708: 4118:"Severe Low Blood Sugar (Hypoglycemia) Treatment | Lilly GLUCAGON" 1247:, is associated with hypoglycemia. This is a tumor located in the 977: 966: 709: 685: 658: 316: 148: 106: 4117: 905:

Other causes of hypoglycemia in diabetics include the following:

4458:

National Institute of Diabetes and Digestive and Kidney Diseases

3038:

National Institute of Diabetes and Digestive and Kidney Diseases

1182:

Disorders that are related to the breakdown of glycogen, called

69:

Hypoglycemia (left) and normal blood sugar concentration (right)

4988: 4773: 1472:, imaging is the most reliable diagnostic technique, including 55:

Hypoglycaemia, hypoglycæmia, low blood glucose, low blood sugar

4529:"Non-Diabetic Hypoglycemia | Causes, Symptoms & Treatment" 3059:"Hangry is officially a word in the Oxford English Dictionary" 1167:

that are associated with the improper breakdown or storage of

792:

Hypoglycemia is most common in those with diabetes treated by

373:

is a blood-sugar level below 70 mg/dL (3.9 mmol/L).

1681:

An insulin pump used to deliver appropriate levels of insulin

3196:

Rix I, Nexøe-Larsen C, Bergmann NC, Lund A, Knop FK (2000).

1013:. Finally, very low quality evidence implicates a number of 3298:"Hypoglycaemia and its management in primary care setting" 1834:, hypoglycemia causes death in 6–10% of type 1 diabetics. 1657:

decrease insulin levels, increasing blood glucose levels.

917:, as there is a long period of time without glucose intake 1526:

Soda or a soft-drink, 4 ounces or 1/2 cup (not diet soda)

1215:

and amino acid acidemias, especially those involving the

657:

production and release, adjust glucose production by the

4184:

Pasala S, Dendy JA, Chockalingam V, Meadows RY (2013).

1751:. In some cases, those with non-B cell tumors may have 299:. Other causes of hypoglycemia include severe illness, 4223: 4221: 1845:, because medications that treat type 2 diabetes like 929:, as insulin cannot be cleared out of circulation well 3859:"Disorders of Organic Acid and Amino Acid Metabolism" 1520:

Glucose tabs or gel (refer to instructions on packet)

700:

breakdown that results in the production of glucose.

4579: 4351:

Azhar A, Gillani SW, Mohiuddin G, Majeed RA (2020).

3466:

The Journal of Clinical Endocrinology and Metabolism

2231:

The Journal of Clinical Endocrinology and Metabolism

1133:, may experience hypoglycemia after long periods of 210:

In type 1 diabetics, 6–10% will die of hypoglycemia.

5531: 5491: 5484: 5454: 5431: 5422: 5392: 5313: 5270: 5208: 5178: 5135: 5088: 5023: 4956: 4920: 4881: 4812: 4712: 4583: 1129:Children with primary adrenal failure, also called 206: 198: 182: 171: 158: 120: 112: 96: 85: 73: 51: 46: 3361:Martín-Timón I, Del Cañizo-Gómez FJ (July 2015). 1401:In those with a history of diabetes treated with 1275:Hypoglycemia may occur in people with non-B cell 2548: 2546: 2544: 2542: 2540: 2538: 2536: 2534: 2532: 2530: 2528: 2526: 2524: 2522: 2520: 2518: 2516: 2514: 2512: 2510: 2508: 2506: 2504: 2502: 2500: 2498: 2496: 2494: 2492: 2490: 2488: 2486: 2484: 2482: 2480: 2478: 2476: 2474: 2472: 2470: 2468: 2466: 2464: 2462: 1586:A glucagon kit used to treat severe hypoglycemia 276:, or death. Symptoms typically come on quickly. 3558:. Treasure Island (FL): StatPearls Publishing. 3514:. Treasure Island (FL): StatPearls Publishing. 3165:. Treasure Island (FL): StatPearls Publishing. 2893:, Treasure Island (FL): StatPearls Publishing, 2460: 2458: 2456: 2454: 2452: 2450: 2448: 2446: 2444: 2442: 2440: 2438: 2436: 2434: 2432: 2430: 2428: 2426: 2424: 2422: 2420: 2418: 2416: 2414: 2412: 2410: 2408: 2406: 2404: 2402: 2400: 2398: 2396: 2394: 2392: 2390: 2388: 2386: 2384: 2382: 2380: 2378: 2376: 2374: 2372: 2370: 2368: 2366: 2364: 2362: 2360: 2358: 2356: 2354: 2352: 2350: 2348: 2346: 2344: 2342: 2340: 2338: 2336: 2334: 2332: 2330: 2328: 2326: 2324: 2322: 2320: 2318: 2316: 2314: 2312: 2310: 2308: 2306: 2304: 2302: 2300: 2298: 2296: 2294: 2292: 2290: 2288: 2286: 2284: 2282: 1141:, which leads to decreased glucose production. 865:Recurrent episodes of hypoglycemia can lead to 32:Not to be confused with the opposite disorder, 2280: 2278: 2276: 2274: 2272: 2270: 2268: 2266: 2264: 2262: 1830:, requiring treatment assistance. In terms of 720:is the process of glucose production from non- 5000: 4785: 1295:Post-gastric bypass postprandial hypoglycemia 8: 4409:The American Journal of the Medical Sciences 4357:Journal of Pharmacy & Bioallied Sciences 2727: 2725: 2723: 2614: 2612: 2610: 4303:The Cochrane Database of Systematic Reviews 4074:The Cochrane Database of Systematic Reviews 4022:The Cochrane Database of Systematic Reviews 3795:Levtova A, Waters PJ, Buhas D, Lévesque S, 1591:Treatment by family, friends, or co-workers 1451:Response of blood glucose level to glucagon 1221:combined malonic and methylmalonic aciduria 5488: 5428: 5007: 4993: 4985: 4792: 4778: 4770: 4580: 3894:"Adrenocortical Carcinoma Treatment - NCI" 3550:Jeanmonod R, Asuka E, Jeanmonod D (2022). 3034:"Low Blood Glucose (Hypoglycemia) - NIDDK" 2665:: CS1 maint: location missing publisher ( 2599:: CS1 maint: location missing publisher ( 2556:Harrison's principles of internal medicine 2220: 2218: 2216: 2214: 2212: 2210: 2208: 2206: 2204: 2202: 2200: 2198: 2196: 2194: 2192: 2190: 2188: 2186: 2184: 2182: 2180: 2178: 2176: 2174: 2172: 2170: 2168: 2166: 2164: 2162: 2160: 2158: 2156: 2154: 2152: 2150: 2148: 2146: 2144: 2142: 2140: 2138: 2136: 2134: 2132: 2130: 2128: 2126: 2124: 2122: 2120: 2118: 2116: 2114: 2112: 2110: 2108: 2106: 2104: 2102: 2100: 2098: 2096: 2094: 2092: 2090: 2088: 2086: 2084: 2082: 2080: 2078: 2076: 2074: 2072: 2070: 2018: 2016: 2014: 2012: 2010: 2008: 2006: 2004: 2002: 2000: 1998: 1996: 1994: 1992: 1990: 1988: 1986: 1984: 1982: 1980: 1978: 1976: 1974: 1972: 1970: 1968: 1966: 1841:, hypoglycemia is less common compared to 1325:can be formed against insulin, leading to 252:, tiredness, clumsiness, trouble talking, 60: 43: 4957:Other pancreatic disorders and conditions 4378: 4368: 4322: 4201: 4093: 4041: 3947: 3724: 3666: 3506:Awad DH, Gokarakonda SB, Ilahi M (2022). 3388: 3378: 2823: 2759: 2749: 2242: 2068: 2066: 2064: 2062: 2060: 2058: 2056: 2054: 2052: 2050: 1964: 1962: 1960: 1958: 1956: 1954: 1952: 1950: 1948: 1946: 279:The most common cause of hypoglycemia is 3305:Diabetes/Metabolism Research and Reviews 1917:. The term means 'low blood sugar' from 1676: 1581: 1390:in a patient helps to avoid unnecessary 1019:angiotensin converting enzyme inhibitors 724:sources, supplied from muscles and fat. 503: 395:The three conditions are the following: 4454:"Continuous Glucose Monitoring | NIDDK" 3152: 3150: 3148: 3146: 3144: 3142: 3140: 3138: 3136: 3134: 1942: 762:After hypoglycemia has been prolonged, 4402: 4400: 4398: 4063: 4061: 3925: 3923: 3921: 3919: 3917: 3915: 3852: 3850: 3805:Journal of Inherited Metabolic Disease 3589: 3587: 3585: 3545: 3543: 3541: 3356: 3354: 3352: 3350: 3348: 3346: 3344: 3342: 3291: 3289: 3287: 3285: 3283: 3281: 3279: 3235: 3233: 3231: 3229: 3227: 3225: 3223: 3132: 3130: 3128: 3126: 3124: 3122: 3120: 3118: 3116: 3114: 2658: 2592: 1802:Hypoglycemia is common in people with 4493: 4491: 4489: 4487: 4485: 4483: 4481: 4479: 4448: 4446: 4346: 4344: 4342: 4179: 4177: 4175: 4173: 4011: 4009: 4007: 4005: 3633:Baker JJ, Burton BK (November 2021). 3501: 3499: 3497: 3495: 3459: 3457: 3455: 3453: 3451: 3216:from the original on 15 January 2021. 2997: 2995: 2993: 2991: 2989: 2987: 2985: 2983: 2981: 2979: 2801: 2799: 1885:Hypoglycemia was first discovered by 1516:Examples of products to consume are: 1357:Low blood sugar may occur in healthy 549:Difficulty speaking or slurred speech 7: 4575:. U.S. National Library of Medicine. 4464:from the original on 12 January 2022 4158:from the original on 24 January 2022 4128:from the original on 24 January 2022 3570:from the original on 13 October 2021 3526:from the original on 26 January 2022 3014:from the original on 26 January 2022 2797: 2795: 2793: 2791: 2789: 2787: 2785: 2783: 2781: 2779: 2708:from the original on 13 January 2022 2688: 2686: 2684: 2682: 2680: 2678: 2676: 2647:from the original on 26 January 2022 817: 5305:Glycogen phosphorylase isoenzyme BB 3990:from the original on 9 October 2020 3177:from the original on 30 August 2021 2694:American Diabetes Association (ADA) 2581:from the original on 29 August 2021 642:identify the hypoglycemic episode. 3932:"Autoimmune forms of hypoglycemia" 2698:"Hypoglycemia (Low Blood Glucose)" 2025:"Low Blood Glucose (Hypoglycemia)" 1617:Treatment by medical professionals 1613:be called for further assistance. 1532:Table sugar or honey, 1 tablespoon 1291:, which decreases glucose levels. 1283:, adrenocorticoid carcinomas, and 1005:. Low quality evidence implicates 684:. This drop in insulin allows the 25: 2035:from the original on 28 July 2017 909:Fasting, whether it be a planned 4245:from the original on 15 May 2021 2919:"Low Blood Sugar (Hypoglycemia)" 2866:from the original on 17 May 2020 1859:glucagon-like peptide 1 agonists 1608:If the person is unconscious, a 1482:magnetic resonance imaging (MRI) 820:section for more information on 579:Pounding heartbeat (also called 473:Post-gastric bypass hypoglycemia 5564:Disorders of endocrine pancreas 4558:Hypoglycemia at the Mayo Clinic 4499:"Collip discovers hypoglycemia" 3863:Textbook of Clinical Pediatrics 1117:becomes depleted in a state of 995:non-steroidal anti-inflammatory 283:used to treat diabetes such as 4315:10.1002/14651858.cd008101.pub2 4086:10.1002/14651858.CD013283.pub2 4034:10.1002/14651858.cd013283.pub2 1637:glucagon may be administered. 1448:Oral hypoglycemic agent screen 1339:late postprandial hypoglycemia 1267:will be inappropriately high. 1021:(also called ACE-inhibitors), 788:List of causes of hypoglycemia 1: 5262:Comprehensive metabolic panel 4964:Pancreatic beta cell function 4563:American Diabetes Association 3639:TouchREVIEWS in Endocrinology 3552:"Inborn Errors Of Metabolism" 1704:continuous glucose monitoring 1495:American Diabetes Association 1289:insulin-like growth factor II 1035:trimethoprim-sulfamethoxazole 1023:angiotensin receptor blockers 567:Death, if severe hypoglycemia 3871:10.1007/978-3-642-02202-9_38 3766:10.1016/j.bbalip.2019.07.012 3157:Mathew P, Thoppil D (2022). 2885:Mathew P, Thoppil D (2024), 1855:alpha-glucosidase inhibitors 477:Generalized anxiety disorder 5198:Thyroid-stimulating hormone 5160:Total iron-binding capacity 4421:10.1016/j.amjms.2019.07.003 3949:10.1097/MD.0b013e3181a5b42e 2825:10.1016/j.jpeds.2015.03.057 2559:(20th ed.). New York. 1769:alpha-glucosidase inhibitor 1712:Continuous glucose monitors 1347:insulin receptor antibodies 1161:inborn errors of metabolism 1155:Inborn errors of metabolism 325:inborn errors of metabolism 5590: 5574:Disorders causing seizures 5539:Elevated alpha-fetoprotein 4948:Rabson–Mendenhall syndrome 4941:Congenital hyperinsulinism 1747:to reduce the size of the 1468:In those with a suspected 785: 624:Pins and needles sensation 31: 3651:10.17925/EE.2021.17.2.108 3508:"Factitious Hypoglycemia" 3426:10.1007/s11892-018-1065-6 3367:World Journal of Diabetes 2812:The Journal of Pediatrics 2738:World Journal of Diabetes 1889:when he was working with 1555:sublingual administration 1307:postprandial hypoglycemia 1251:. An insulinoma produces 1185:glycogen storage diseases 1082:surreptitious insulin use 1076:Surreptitious insulin use 770:are released to continue 665:, in an organ called the 634: 601:Nervousness (also called 507:Neuroglycopenic symptoms 481:Surreptitious insulin use 68: 59: 4148:"Glucacon Emergency Kit" 3600:Seminars in Perinatology 3414:Current Diabetes Reports 1921:ὑπογλυκαιμία, from ὑπο- 1478:computed tomography (CT) 1301:Roux-en-Y gastric bypass 1217:oxidation of fatty acids 1025:(also called ARBs), and 884:Neuroglycopenic symptoms 867:hypoglycemic unawareness 861:Hypoglycemic unawareness 5068:BUN-to-creatinine ratio 3254:10.1111/1753-0407.12933 1863:dipeptidyl peptidase IV 1318:Autoimmune hypoglycemia 1312:glucagon-like peptide-1 1147:, leading to decreased 1086:factitious hypoglycemia 1049:, and chemotherapeutic 1037:, progesterone blocker 751:works to also increase 731:is signaled to release 527:Tiredness (also called 27:Decrease in blood sugar 5501:Elevated transaminases 5193:Thyroid function tests 5155:Transferrin saturation 5015:Clinical biochemistry 4370:10.4103/jpbs.JPBS_7_20 4152:Glucagon Emergency Kit 1682: 1587: 1229:methylmalonic acidemia 1017:medications including 1001:and the anti-malarial 456:Valvular heart disease 436:Differential diagnosis 323:or non-B cell tumors, 5295:Lactate dehydrogenase 5257:Basic metabolic panel 5188:ACTH stimulation test 4122:www.lillyglucagon.com 3380:10.4239/wjd.v6.i7.912 3198:"Glucagon Physiology" 2862:. 11 September 2019. 1806:, and in people with 1680: 1585: 1550:buccal administration 1353:Neonatal hypoglycemia 1027:β-adrenergic blockers 558:Loss of consciousness 460:Postprandial syndrome 380: 270:loss of consciousness 175:Eating foods high in 103:Loss of consciousness 5315:Liver function tests 5170:Transferrin receptor 3612:10.1053/sp.2000.6367 3478:10.1210/jc.2008-1416 2751:10.4239/wjd.v6.i1.30 2244:10.1210/jc.2008-1410 1443:Beta-hydroxybutyrate 1382:. The components of 1305:post-gastric bypass 1163:are a group of rare 510:Adrenergic symptoms 235:), sometimes called 5569:Medical emergencies 5331:Serum total protein 5326:Human serum albumin 4509:on 8 September 2017 4278:on 28 February 2019 4271:Nursing in Practice 4190:The Ochsner Journal 3242:Journal of Diabetes 2622:Blueprints medicine 1575:, and how to use a 1546:oral administration 1374:Diagnostic approach 1335:autoimmune disorder 1094:factitious disorder 945:intensive care unit 888:Adrenergic symptoms 5103:Arterial blood gas 4931:Insulin resistance 4806:glucose metabolism 4713:External resources 4535:. 21 November 2023 4236:Accessdate.fsa.gov 3817:10.1002/jimd.12032 1683: 1588: 1392:diagnostic testing 1225:propionic acidemia 1125:Hormone deficiency 1041:, anti-arrhythmic 892:Signs and Symptoms 816:. Please refer to 696:is the process of 560:(sometimes called 489:Signs and symptoms 451:Cardiac arrhythmia 401:Signs and Symptoms 371:low blood glucose, 5551: 5550: 5547: 5546: 5480: 5479: 5433:Blood sugar level 5412:Pancreatic lipase 5250:Total cholesterol 5080:Serum osmolal gap 5075:Plasma osmolality 4982: 4981: 4871:Template:Diabetes 4767: 4766: 4503:Treating Diabetes 3880:978-3-642-02201-2 3760:(11): 1629–1643. 3594:Ozand PT (2000). 3317:10.1002/dmrr.3332 2954:10.2337/dc20-0876 2923:diabetesdaily.com 2632:978-1-4698-6415-0 2619:Young VB (2016). 2566:978-1-259-64403-0 1925:'under' + γλυκύς 1891:Frederick Banting 1729:Addison's disease 1271:Non-B cell tumors 1239:A primary B-cell 1165:genetic disorders 1131:Addison's disease 1045:, anti-coagulant 639: 638: 446:drug intoxication 214: 213: 160:Diagnostic method 41:Medical condition 16:(Redirected from 5581: 5523:Hyperproteinemia 5489: 5429: 5009: 5002: 4995: 4986: 4898:Oxyhyperglycemia 4794: 4787: 4780: 4771: 4581: 4576: 4545: 4544: 4542: 4540: 4525: 4519: 4518: 4516: 4514: 4505:. Archived from 4495: 4474: 4473: 4471: 4469: 4450: 4441: 4440: 4404: 4393: 4392: 4382: 4372: 4348: 4337: 4336: 4326: 4294: 4288: 4287: 4285: 4283: 4274:. Archived from 4261: 4255: 4254: 4252: 4250: 4244: 4233: 4225: 4216: 4215: 4205: 4181: 4168: 4167: 4165: 4163: 4144: 4138: 4137: 4135: 4133: 4114: 4108: 4107: 4097: 4065: 4056: 4055: 4045: 4013: 4000: 3999: 3997: 3995: 3976: 3970: 3969: 3951: 3927: 3910: 3909: 3907: 3905: 3890: 3884: 3883: 3854: 3845: 3844: 3792: 3786: 3785: 3745: 3739: 3738: 3728: 3687: 3681: 3680: 3670: 3630: 3624: 3623: 3591: 3580: 3579: 3577: 3575: 3547: 3536: 3535: 3533: 3531: 3503: 3490: 3489: 3461: 3446: 3445: 3409: 3403: 3402: 3392: 3382: 3358: 3337: 3336: 3302: 3293: 3274: 3273: 3237: 3218: 3217: 3193: 3187: 3186: 3184: 3182: 3154: 3109: 3108: 3106: 3104: 3082: 3076: 3075: 3073: 3071: 3055: 3049: 3048: 3046: 3044: 3030: 3024: 3023: 3021: 3019: 3008:www.uptodate.com 2999: 2974: 2973: 2933: 2927: 2926: 2925:. 8 August 2021. 2915: 2909: 2908: 2907: 2905: 2882: 2876: 2875: 2873: 2871: 2852: 2846: 2845: 2827: 2803: 2774: 2773: 2763: 2753: 2729: 2718: 2717: 2715: 2713: 2702:www.diabetes.org 2690: 2671: 2670: 2664: 2656: 2654: 2652: 2616: 2605: 2604: 2598: 2590: 2588: 2586: 2550: 2257: 2256: 2246: 2222: 2045: 2044: 2042: 2040: 2020: 1843:type 1 diabetics 1641:Other treatments 1396:healthcare costs 1206:Fanconi syndrome 1011:bipolar disorder 536:Unusual behavior 504: 469:Pheochromocytoma 223:), also spelled 221:American English 64: 44: 21: 5589: 5588: 5584: 5583: 5582: 5580: 5579: 5578: 5554: 5553: 5552: 5543: 5527: 5516:Hypoalbuminemia 5511:Hypoproteinemia 5476: 5450: 5424:Small molecules 5418: 5388: 5309: 5266: 5204: 5174: 5131: 5121: 5084: 5019: 5013: 4983: 4978: 4952: 4936:Hyperinsulinism 4916: 4910:Whipple's triad 4877: 4808: 4800:Disease of the 4798: 4768: 4763: 4762: 4708: 4707: 4592: 4567: 4554: 4549: 4548: 4538: 4536: 4527: 4526: 4522: 4512: 4510: 4497: 4496: 4477: 4467: 4465: 4452: 4451: 4444: 4406: 4405: 4396: 4350: 4349: 4340: 4309:(1): CD008101. 4296: 4295: 4291: 4281: 4279: 4263: 4262: 4258: 4248: 4246: 4242: 4231: 4227: 4226: 4219: 4183: 4182: 4171: 4161: 4159: 4146: 4145: 4141: 4131: 4129: 4116: 4115: 4111: 4080:(4): CD013283. 4067: 4066: 4059: 4028:(4): CD013283. 4015: 4014: 4003: 3993: 3991: 3978: 3977: 3973: 3929: 3928: 3913: 3903: 3901: 3892: 3891: 3887: 3881: 3856: 3855: 3848: 3794: 3793: 3789: 3747: 3746: 3742: 3697:Nature Genetics 3689: 3688: 3684: 3632: 3631: 3627: 3593: 3592: 3583: 3573: 3571: 3549: 3548: 3539: 3529: 3527: 3505: 3504: 3493: 3463: 3462: 3449: 3411: 3410: 3406: 3360: 3359: 3340: 3300: 3295: 3294: 3277: 3239: 3238: 3221: 3195: 3194: 3190: 3180: 3178: 3156: 3155: 3112: 3102: 3100: 3092:. 9 July 2018. 3090:Washington Post 3084: 3083: 3079: 3069: 3067: 3057: 3056: 3052: 3042: 3040: 3032: 3031: 3027: 3017: 3015: 3001: 3000: 2977: 2935: 2934: 2930: 2917: 2916: 2912: 2903: 2901: 2884: 2883: 2879: 2869: 2867: 2854: 2853: 2849: 2805: 2804: 2777: 2731: 2730: 2721: 2711: 2709: 2692: 2691: 2674: 2657: 2650: 2648: 2633: 2618: 2617: 2608: 2591: 2584: 2582: 2567: 2552: 2551: 2260: 2224: 2223: 2048: 2038: 2036: 2022: 2021: 1944: 1939: 1929:'sweet' + αἷμᾰ 1900: 1883: 1839:type 2 diabetes 1808:type 2 diabetes 1804:type 1 diabetes 1800: 1753:hormone therapy 1737:hypopituitarism 1721: 1688: 1675: 1665:The soft drink 1643: 1619: 1593: 1568: 1540:bioavailability 1507: 1490: 1388:Whipple's triad 1384:Whipple's triad 1380:Whipple's triad 1376: 1355: 1320: 1297: 1273: 1237: 1157: 1145:Hypopituitarism 1127: 1110: 1078: 991: 941: 939:Serious illness 936: 903: 863: 843: 838: 818:Pathophysiology 790: 784: 772:gluconeogenesis 753:gluconeogenesis 741:gluconeogenesis 718:Gluconeogenesis 706:gluconeogenesis 680:release by the 648: 646:Pathophysiology 628:Pale skin color 575:Fast heart rate 545:Lightheadedness 495:neuroglycopenic 491: 464:Hyperthyroidism 438: 416: 389:Whipple's triad 383: 381:Whipple's triad 367:low blood sugar 360: 258:fast heart rate 245:Whipple's triad 239:, is a fall in 237:low blood sugar 233:British English 165:Whipple's triad 42: 37: 28: 23: 22: 15: 12: 11: 5: 5587: 5585: 5577: 5576: 5571: 5566: 5556: 5555: 5549: 5548: 5545: 5544: 5542: 5541: 5535: 5533: 5529: 5528: 5526: 5525: 5520: 5519: 5518: 5508: 5503: 5497: 5495: 5486: 5482: 5481: 5478: 5477: 5475: 5474: 5469: 5464: 5458: 5456: 5452: 5451: 5449: 5448: 5443: 5437: 5435: 5426: 5420: 5419: 5417: 5416: 5415: 5414: 5404: 5398: 5396: 5390: 5389: 5387: 5386: 5385: 5384: 5379: 5369: 5364: 5363: 5362: 5357: 5352: 5340: 5335: 5334: 5333: 5328: 5319: 5317: 5311: 5310: 5308: 5307: 5302: 5297: 5292: 5287: 5282: 5280:Cardiac marker 5276: 5274: 5272:Cardiovascular 5268: 5267: 5265: 5264: 5259: 5254: 5253: 5252: 5247: 5242: 5237: 5227: 5226: 5225: 5223:Hemoglobin A1c 5214: 5212: 5206: 5205: 5203: 5202: 5201: 5200: 5190: 5184: 5182: 5176: 5175: 5173: 5172: 5167: 5162: 5157: 5152: 5147: 5141: 5139: 5133: 5132: 5130: 5129: 5124: 5119: 5115: 5110: 5105: 5100: 5094: 5092: 5086: 5085: 5083: 5082: 5077: 5072: 5071: 5070: 5065: 5060: 5053:Renal function 5050: 5045: 5040: 5035: 5029: 5027: 5021: 5020: 5014: 5012: 5011: 5004: 4997: 4989: 4980: 4979: 4977: 4976: 4971: 4966: 4960: 4958: 4954: 4953: 4951: 4950: 4945: 4944: 4943: 4933: 4927: 4925: 4918: 4917: 4915: 4914: 4913: 4912: 4902: 4901: 4900: 4889: 4887: 4879: 4878: 4876: 4875: 4874: 4873: 4862: 4861: 4860: 4837: 4832: 4827: 4818: 4816: 4810: 4809: 4799: 4797: 4796: 4789: 4782: 4774: 4765: 4764: 4761: 4760: 4749: 4729: 4717: 4716: 4714: 4710: 4709: 4706: 4705: 4694: 4683: 4644: 4625: 4593: 4588: 4587: 4585: 4584:Classification 4578: 4577: 4569:"Hypoglycemia" 4565: 4560: 4553: 4552:External links 4550: 4547: 4546: 4520: 4475: 4442: 4415:(5): 332–339. 4394: 4363:(2): 102–111. 4338: 4289: 4256: 4217: 4196:(3): 407–412. 4169: 4139: 4109: 4057: 4001: 3971: 3942:(3): 141–153. 3911: 3898:www.cancer.gov 3885: 3879: 3846: 3811:(1): 107–116. 3787: 3740: 3709:10.1038/ng.908 3703:(9): 883–886. 3682: 3645:(2): 108–111. 3625: 3606:(2): 172–193. 3581: 3537: 3491: 3472:(3): 741–745. 3447: 3404: 3373:(7): 912–926. 3338: 3275: 3248:(9): 711–718. 3219: 3188: 3159:"Hypoglycemia" 3110: 3077: 3050: 3025: 2975: 2948:(4): 915–924. 2928: 2910: 2887:"Hypoglycemia" 2877: 2847: 2818:(2): 238–245. 2775: 2719: 2672: 2631: 2606: 2565: 2258: 2237:(3): 709–728. 2046: 1941: 1940: 1938: 1935: 1899: 1896: 1882: 1879: 1837:In those with 1799: 1796: 1761:glucocorticoid 1757:growth hormone 1733:growth hormone 1720: 1717: 1687: 1684: 1674: 1671: 1642: 1639: 1618: 1615: 1592: 1589: 1567: 1564: 1534: 1533: 1530: 1527: 1524: 1521: 1506: 1505:Self-treatment 1503: 1489: 1486: 1459: 1458: 1452: 1449: 1446: 1440: 1434: 1428: 1425: 1418:Plasma glucose 1394:and decreases 1375: 1372: 1354: 1351: 1329:hypoglycemia. 1319: 1316: 1296: 1293: 1272: 1269: 1236: 1233: 1156: 1153: 1149:growth hormone 1126: 1123: 1109: 1108:Alcohol misuse 1106: 1077: 1074: 1072:hypoglycemia. 1051:mercaptopurine 990: 987: 985:hypoglycemia. 940: 937: 935: 932: 931: 930: 927:Kidney disease 924: 921: 918: 902: 899: 862: 859: 842: 839: 837: 834: 786:Main article: 783: 780: 776:glycogenolysis 768:growth hormone 757:glycogenolysis 694:Glycogenolysis 690:glycogenolysis 647: 644: 637: 636: 632: 631: 630: 629: 626: 621: 616: 611: 608: 599: 594: 591: 586: 577: 570: 569: 568: 565: 555: 550: 547: 542: 537: 534: 525: 523:Blurred vision 520: 512: 511: 508: 490: 487: 486: 485: 482: 479: 474: 471: 466: 461: 458: 453: 448: 437: 434: 415: 412: 411: 410: 407: 404: 382: 379: 365:, also called 359: 356: 305:kidney failure 212: 211: 208: 204: 203: 200: 196: 195: 186: 180: 179: 173: 169: 168: 162: 156: 155: 145:kidney failure 122: 118: 117: 114: 110: 109: 100: 94: 93: 89: 83: 82: 77: 71: 70: 66: 65: 57: 56: 53: 49: 48: 40: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 5586: 5575: 5572: 5570: 5567: 5565: 5562: 5561: 5559: 5540: 5537: 5536: 5534: 5530: 5524: 5521: 5517: 5514: 5513: 5512: 5509: 5507: 5504: 5502: 5499: 5498: 5496: 5494: 5490: 5487: 5483: 5473: 5470: 5468: 5467:Hyperuricemia 5465: 5463: 5460: 5459: 5457: 5453: 5447: 5446:Hyperglycemia 5444: 5442: 5439: 5438: 5436: 5434: 5430: 5427: 5425: 5421: 5413: 5410: 5409: 5408: 5405: 5403: 5400: 5399: 5397: 5395: 5391: 5383: 5380: 5378: 5375: 5374: 5373: 5370: 5368: 5365: 5361: 5360:AST/ALT ratio 5358: 5356: 5353: 5351: 5348: 5347: 5346: 5345: 5344:transaminases 5341: 5339: 5336: 5332: 5329: 5327: 5324: 5323: 5321: 5320: 5318: 5316: 5312: 5306: 5303: 5301: 5298: 5296: 5293: 5291: 5288: 5286: 5285:Troponin test 5283: 5281: 5278: 5277: 5275: 5273: 5269: 5263: 5260: 5258: 5255: 5251: 5248: 5246: 5245:Triglycerides 5243: 5241: 5238: 5236: 5233: 5232: 5231: 5228: 5224: 5221: 5220: 5219: 5218:Blood glucose 5216: 5215: 5213: 5211: 5207: 5199: 5196: 5195: 5194: 5191: 5189: 5186: 5185: 5183: 5181: 5177: 5171: 5168: 5166: 5163: 5161: 5158: 5156: 5153: 5151: 5148: 5146: 5143: 5142: 5140: 5138: 5134: 5128: 5125: 5123: 5116: 5114: 5111: 5109: 5106: 5104: 5101: 5099: 5096: 5095: 5093: 5091: 5087: 5081: 5078: 5076: 5073: 5069: 5066: 5064: 5061: 5059: 5056: 5055: 5054: 5051: 5049: 5046: 5044: 5041: 5039: 5036: 5034: 5031: 5030: 5028: 5026: 5022: 5018: 5010: 5005: 5003: 4998: 4996: 4991: 4990: 4987: 4975: 4972: 4970: 4967: 4965: 4962: 4961: 4959: 4955: 4949: 4946: 4942: 4939: 4938: 4937: 4934: 4932: 4929: 4928: 4926: 4923: 4919: 4911: 4908: 4907: 4906: 4903: 4899: 4896: 4895: 4894: 4893:Hyperglycemia 4891: 4890: 4888: 4885: 4884:blood glucose 4880: 4872: 4868: 4867: 4866: 4865:Complications 4863: 4859: 4856: 4853: 4850: 4847: 4844: 4841: 4838: 4836: 4833: 4831: 4828: 4826: 4823: 4822: 4820: 4819: 4817: 4815: 4811: 4807: 4803: 4795: 4790: 4788: 4783: 4781: 4776: 4775: 4772: 4759: 4755: 4754: 4750: 4748: 4745: 4742: 4739: 4735: 4734: 4730: 4728: 4724: 4723: 4719: 4718: 4715: 4711: 4704: 4700: 4699: 4695: 4693: 4689: 4688: 4684: 4682: 4678: 4674: 4670: 4666: 4662: 4658: 4654: 4653: 4649: 4645: 4643: 4639: 4635: 4634: 4630: 4626: 4624: 4620: 4616: 4612: 4608: 4604: 4603: 4599: 4595: 4594: 4591: 4586: 4582: 4574: 4570: 4566: 4564: 4561: 4559: 4556: 4555: 4551: 4534: 4530: 4524: 4521: 4508: 4504: 4500: 4494: 4492: 4490: 4488: 4486: 4484: 4482: 4480: 4476: 4463: 4459: 4455: 4449: 4447: 4443: 4438: 4434: 4430: 4426: 4422: 4418: 4414: 4410: 4403: 4401: 4399: 4395: 4390: 4386: 4381: 4376: 4371: 4366: 4362: 4358: 4354: 4347: 4345: 4343: 4339: 4334: 4330: 4325: 4320: 4316: 4312: 4308: 4304: 4300: 4293: 4290: 4277: 4273: 4272: 4267: 4260: 4257: 4241: 4237: 4230: 4224: 4222: 4218: 4213: 4209: 4204: 4199: 4195: 4191: 4187: 4180: 4178: 4176: 4174: 4170: 4157: 4153: 4149: 4143: 4140: 4127: 4123: 4119: 4113: 4110: 4105: 4101: 4096: 4091: 4087: 4083: 4079: 4075: 4071: 4064: 4062: 4058: 4053: 4049: 4044: 4039: 4035: 4031: 4027: 4023: 4019: 4012: 4010: 4008: 4006: 4002: 3989: 3985: 3981: 3975: 3972: 3967: 3963: 3959: 3955: 3950: 3945: 3941: 3937: 3933: 3926: 3924: 3922: 3920: 3918: 3916: 3912: 3900:. 6 July 2007 3899: 3895: 3889: 3886: 3882: 3876: 3872: 3868: 3864: 3860: 3853: 3851: 3847: 3842: 3838: 3834: 3830: 3826: 3822: 3818: 3814: 3810: 3806: 3802: 3798: 3797:Auray-Blais C 3791: 3788: 3783: 3779: 3775: 3771: 3767: 3763: 3759: 3755: 3751: 3744: 3741: 3736: 3732: 3727: 3722: 3718: 3714: 3710: 3706: 3702: 3698: 3694: 3686: 3683: 3678: 3674: 3669: 3664: 3660: 3656: 3652: 3648: 3644: 3640: 3636: 3629: 3626: 3621: 3617: 3613: 3609: 3605: 3601: 3597: 3590: 3588: 3586: 3582: 3569: 3565: 3561: 3557: 3553: 3546: 3544: 3542: 3538: 3525: 3521: 3517: 3513: 3509: 3502: 3500: 3498: 3496: 3492: 3487: 3483: 3479: 3475: 3471: 3467: 3460: 3458: 3456: 3454: 3452: 3448: 3443: 3439: 3435: 3431: 3427: 3423: 3419: 3415: 3408: 3405: 3400: 3396: 3391: 3386: 3381: 3376: 3372: 3368: 3364: 3357: 3355: 3353: 3351: 3349: 3347: 3345: 3343: 3339: 3334: 3330: 3326: 3322: 3318: 3314: 3310: 3306: 3299: 3292: 3290: 3288: 3286: 3284: 3282: 3280: 3276: 3271: 3267: 3263: 3259: 3255: 3251: 3247: 3243: 3236: 3234: 3232: 3230: 3228: 3226: 3224: 3220: 3215: 3211: 3207: 3203: 3199: 3192: 3189: 3176: 3172: 3168: 3164: 3160: 3153: 3151: 3149: 3147: 3145: 3143: 3141: 3139: 3137: 3135: 3133: 3131: 3129: 3127: 3125: 3123: 3121: 3119: 3117: 3115: 3111: 3099: 3095: 3091: 3087: 3081: 3078: 3066: 3065: 3060: 3054: 3051: 3039: 3035: 3029: 3026: 3013: 3009: 3005: 2998: 2996: 2994: 2992: 2990: 2988: 2986: 2984: 2982: 2980: 2976: 2971: 2967: 2963: 2959: 2955: 2951: 2947: 2943: 2942:Diabetes Care 2939: 2932: 2929: 2924: 2920: 2914: 2911: 2900: 2896: 2892: 2888: 2881: 2878: 2865: 2861: 2857: 2851: 2848: 2843: 2839: 2835: 2831: 2826: 2821: 2817: 2813: 2809: 2802: 2800: 2798: 2796: 2794: 2792: 2790: 2788: 2786: 2784: 2782: 2780: 2776: 2771: 2767: 2762: 2757: 2752: 2747: 2743: 2739: 2735: 2728: 2726: 2724: 2720: 2707: 2703: 2699: 2695: 2689: 2687: 2685: 2683: 2681: 2679: 2677: 2673: 2668: 2662: 2646: 2642: 2638: 2634: 2628: 2624: 2623: 2615: 2613: 2611: 2607: 2602: 2596: 2580: 2576: 2572: 2568: 2562: 2558: 2557: 2549: 2547: 2545: 2543: 2541: 2539: 2537: 2535: 2533: 2531: 2529: 2527: 2525: 2523: 2521: 2519: 2517: 2515: 2513: 2511: 2509: 2507: 2505: 2503: 2501: 2499: 2497: 2495: 2493: 2491: 2489: 2487: 2485: 2483: 2481: 2479: 2477: 2475: 2473: 2471: 2469: 2467: 2465: 2463: 2461: 2459: 2457: 2455: 2453: 2451: 2449: 2447: 2445: 2443: 2441: 2439: 2437: 2435: 2433: 2431: 2429: 2427: 2425: 2423: 2421: 2419: 2417: 2415: 2413: 2411: 2409: 2407: 2405: 2403: 2401: 2399: 2397: 2395: 2393: 2391: 2389: 2387: 2385: 2383: 2381: 2379: 2377: 2375: 2373: 2371: 2369: 2367: 2365: 2363: 2361: 2359: 2357: 2355: 2353: 2351: 2349: 2347: 2345: 2343: 2341: 2339: 2337: 2335: 2333: 2331: 2329: 2327: 2325: 2323: 2321: 2319: 2317: 2315: 2313: 2311: 2309: 2307: 2305: 2303: 2301: 2299: 2297: 2295: 2293: 2291: 2289: 2287: 2285: 2283: 2281: 2279: 2277: 2275: 2273: 2271: 2269: 2267: 2265: 2263: 2259: 2254: 2250: 2245: 2240: 2236: 2232: 2228: 2221: 2219: 2217: 2215: 2213: 2211: 2209: 2207: 2205: 2203: 2201: 2199: 2197: 2195: 2193: 2191: 2189: 2187: 2185: 2183: 2181: 2179: 2177: 2175: 2173: 2171: 2169: 2167: 2165: 2163: 2161: 2159: 2157: 2155: 2153: 2151: 2149: 2147: 2145: 2143: 2141: 2139: 2137: 2135: 2133: 2131: 2129: 2127: 2125: 2123: 2121: 2119: 2117: 2115: 2113: 2111: 2109: 2107: 2105: 2103: 2101: 2099: 2097: 2095: 2093: 2091: 2089: 2087: 2085: 2083: 2081: 2079: 2077: 2075: 2073: 2071: 2069: 2067: 2065: 2063: 2061: 2059: 2057: 2055: 2053: 2051: 2047: 2034: 2030: 2029:NIDDK.nih.gov 2026: 2019: 2017: 2015: 2013: 2011: 2009: 2007: 2005: 2003: 2001: 1999: 1997: 1995: 1993: 1991: 1989: 1987: 1985: 1983: 1981: 1979: 1977: 1975: 1973: 1971: 1969: 1967: 1965: 1963: 1961: 1959: 1957: 1955: 1953: 1951: 1949: 1947: 1943: 1936: 1934: 1932: 1928: 1924: 1920: 1916: 1912: 1911:hypoglycaemia 1909: 1905: 1897: 1895: 1892: 1888: 1880: 1878: 1876: 1872: 1868: 1864: 1860: 1856: 1852: 1848: 1844: 1840: 1835: 1833: 1829: 1825: 1821: 1817: 1813: 1809: 1805: 1797: 1795: 1794:may be used. 1793: 1789: 1785: 1780: 1778: 1774: 1770: 1766: 1762: 1758: 1754: 1750: 1746: 1742: 1738: 1734: 1730: 1726: 1719:Non-diabetics 1718: 1716: 1713: 1709: 1708:insulin pumps 1706:systems with 1705: 1701: 1697: 1693: 1685: 1679: 1672: 1670: 1668: 1663: 1660: 1656: 1652: 1648: 1640: 1638: 1636: 1632: 1631:intramuscular 1628: 1624: 1616: 1614: 1611: 1606: 1603: 1599: 1598:glucose meter 1590: 1584: 1580: 1578: 1577:glucose meter 1574: 1565: 1563: 1560: 1558: 1556: 1551: 1547: 1542: 1541: 1531: 1528: 1525: 1522: 1519: 1518: 1517: 1514: 1512: 1504: 1502: 1500: 1496: 1487: 1485: 1483: 1480:imaging, and 1479: 1475: 1471: 1466: 1464: 1457: 1453: 1450: 1447: 1444: 1441: 1438: 1435: 1432: 1429: 1427:Insulin level 1426: 1423: 1422:point-of-care 1419: 1416: 1415: 1414: 1412: 1408: 1404: 1399: 1397: 1393: 1389: 1385: 1381: 1373: 1371: 1368: 1364: 1360: 1352: 1350: 1348: 1344: 1340: 1336: 1332: 1328: 1324: 1317: 1315: 1313: 1309: 1308: 1302: 1294: 1292: 1290: 1286: 1282: 1278: 1270: 1268: 1266: 1262: 1258: 1254: 1250: 1246: 1243:, such as an 1242: 1234: 1232: 1230: 1226: 1222: 1218: 1214: 1209: 1207: 1204:, as well as 1203: 1199: 1195: 1191: 1187: 1186: 1180: 1178: 1174: 1173:carbohydrates 1170: 1166: 1162: 1154: 1152: 1150: 1146: 1142: 1140: 1136: 1132: 1124: 1122: 1120: 1116: 1107: 1105: 1103: 1099: 1095: 1091: 1087: 1083: 1075: 1073: 1071: 1067: 1066:sulfonylureas 1063: 1059: 1054: 1052: 1048: 1044: 1040: 1036: 1032: 1028: 1024: 1020: 1016: 1012: 1008: 1004: 1000: 996: 988: 986: 983: 979: 974: 972: 968: 964: 960: 956: 952: 948: 946: 938: 934:Non-diabetics 933: 928: 925: 922: 919: 916: 913:or overnight 912: 908: 907: 906: 900: 898: 895: 893: 889: 885: 879: 876: 872: 868: 860: 858: 856: 852: 851:sulfonylureas 848: 840: 835: 833: 831: 827: 823: 819: 815: 811: 807: 803: 802:sulfonylureas 799: 795: 789: 781: 779: 777: 773: 769: 765: 760: 758: 754: 750: 746: 742: 738: 734: 730: 725: 723: 719: 715: 711: 707: 703: 699: 695: 691: 687: 683: 679: 674: 672: 668: 664: 660: 656: 652: 645: 643: 633: 627: 625: 622: 620: 617: 615: 612: 609: 606: 605: 600: 598: 595: 592: 590: 587: 584: 583: 578: 576: 573: 572: 571: 566: 563: 559: 556: 554: 551: 548: 546: 543: 541: 538: 535: 532: 531: 526: 524: 521: 519: 516: 515: 514: 513: 509: 506: 505: 502: 500: 496: 488: 483: 480: 478: 475: 472: 470: 467: 465: 462: 459: 457: 454: 452: 449: 447: 443: 442: 441: 435: 433: 429: 426: 422: 413: 408: 405: 402: 398: 397: 396: 393: 391: 390: 378: 374: 372: 368: 364: 357: 355: 352: 348: 347:sulfonylureas 344: 339: 337: 333: 328: 326: 322: 318: 314: 310: 309:liver disease 306: 302: 298: 294: 290: 289:sulfonylureas 286: 282: 277: 275: 271: 267: 264:, shakiness, 263: 259: 255: 251: 246: 242: 238: 234: 230: 226: 225:hypoglycaemia 222: 218: 209: 205: 201: 197: 194: 190: 187: 185: 181: 178: 177:simple sugars 174: 170: 166: 163: 161: 157: 154: 153:liver disease 150: 146: 142: 138: 137:sulfonylureas 134: 130: 126: 123: 119: 115: 111: 108: 104: 101: 99: 98:Complications 95: 90: 88: 84: 81: 80:Endocrinology 78: 76: 72: 67: 63: 58: 54: 50: 45: 39: 35: 34:hyperglycemia 30: 19: 18:Hypoglycaemic 5506:Elevated ALP 5472:Hypouricemia 5441:Hypoglycemia 5440: 5377:Unconjugated 5342: 5025:Electrolytes 4905:Hypoglycemia 4904: 4758:Hypoglycemia 4751: 4731: 4720: 4696: 4685: 4646: 4627: 4596: 4572: 4537:. Retrieved 4532: 4523: 4511:. Retrieved 4507:the original 4502: 4466:. Retrieved 4457: 4412: 4408: 4360: 4356: 4306: 4302: 4292: 4280:. Retrieved 4276:the original 4269: 4259: 4247:. Retrieved 4235: 4193: 4189: 4160:. Retrieved 4151: 4142: 4130:. Retrieved 4121: 4112: 4077: 4073: 4025: 4021: 3992:. Retrieved 3983: 3974: 3939: 3935: 3902:. Retrieved 3897: 3888: 3862: 3808: 3804: 3790: 3757: 3753: 3743: 3700: 3696: 3685: 3642: 3638: 3628: 3603: 3599: 3572:. Retrieved 3555: 3528:. Retrieved 3511: 3469: 3465: 3417: 3413: 3407: 3370: 3366: 3311:(8): e3332. 3308: 3304: 3245: 3241: 3201: 3191: 3179:. Retrieved 3162: 3101:. Retrieved 3089: 3080: 3068:. Retrieved 3062: 3053: 3041:. Retrieved 3037: 3028: 3016:. Retrieved 3007: 2945: 2941: 2931: 2922: 2913: 2902:, retrieved 2890: 2880: 2868:. Retrieved 2859: 2850: 2815: 2811: 2744:(1): 30–36. 2741: 2737: 2710:. Retrieved 2701: 2649:. Retrieved 2621: 2583:. Retrieved 2555: 2234: 2230: 2037:. Retrieved 2028: 1930: 1926: 1922: 1915:hypoglycæmia 1914: 1910: 1908:also spelled 1904:hypoglycemia 1903: 1901: 1887:James Collip 1884: 1875:sulfonylurea 1836: 1827: 1823: 1820:sulfonylurea 1801: 1798:Epidemiology 1781: 1745:chemotherapy 1741:radiotherapy 1722: 1700:sulfonylurea 1689: 1664: 1659:Dasiglucagon 1644: 1620: 1607: 1602:carbohydrate 1594: 1569: 1561: 1553: 1538: 1535: 1515: 1508: 1499:carbohydrate 1491: 1467: 1460: 1411:sulfonylurea 1400: 1377: 1356: 1346: 1338: 1321: 1304: 1298: 1274: 1238: 1227:or isolated 1210: 1184: 1181: 1158: 1143: 1128: 1111: 1085: 1081: 1079: 1055: 1043:disopyramide 1039:mifepristone 1031:levofloxacin 1015:hypertension 999:indomethacin 992: 975: 957:production. 949: 942: 904: 901:Other causes 896: 891: 887: 883: 880: 874: 870: 866: 864: 844: 791: 761: 726: 722:carbohydrate 688:to increase 675: 649: 640: 635:References: 614:Irritability 602: 582:palpitations 580: 561: 528: 492: 439: 430: 417: 400: 394: 387: 384: 375: 370: 366: 363:Hypoglycemia 362: 361: 340: 329: 315:deficiency, 278: 236: 229:hypoglycæmia 228: 224: 217:Hypoglycemia 216: 215: 47:Hypoglycemia 38: 29: 5455:Nitrogenous 5290:CPK-MB test 5230:Lipid panel 5165:Transferrin 5113:Bicarbonate 5108:Base excess 5017:blood tests 4835:gestational 4722:MedlinePlus 4573:MedlinePlus 4282:27 February 4264:Harrold A. 4249:10 November 2870:11 November 1784:insulinomas 1731:or lack of 1635:intra-nasal 1627:intravenous 1623:intravenous 1424:measurement 1420:level, not 1367:epinephrine 1235:Insulinomas 1177:fatty acids 1090:malingering 1009:, used for 841:Medications 749:Epinephrine 745:epinephrine 562:passing out 444:Alcohol or 425:epinephrine 321:insulinomas 281:medications 266:nervousness 241:blood sugar 125:Medications 113:Usual onset 52:Other names 5558:Categories 5382:Conjugated 5210:Metabolism 5150:Serum iron 5137:Iron tests 5058:Creatinine 4969:Insulinoma 4753:Patient UK 4698:DiseasesDB 4468:25 January 4162:24 January 4132:24 January 3994:24 January 3984:Genome.gov 3980:"Antibody" 3574:24 January 3556:StatPearls 3530:21 January 3512:StatPearls 3420:(10): 83. 3181:24 January 3163:StatPearls 3018:14 January 2891:StatPearls 2712:12 January 2651:12 January 2585:12 January 2575:1029074059 2039:12 January 1937:References 1851:glitazones 1792:octreotide 1777:octreotide 1765:octreotide 1673:Prevention 1655:octreotide 1474:ultrasound 1470:insulinoma 1456:antibodies 1437:Proinsulin 1331:Antibodies 1327:autoimmune 1323:Antibodies 1265:proinsulin 1245:insulinoma 1223:(CMAMMA), 1119:starvation 1102:proinsulin 1070:iatrogenic 855:biguanides 593:Clamminess 501:symptoms. 499:adrenergic 358:Definition 351:biguanides 293:biguanides 268:, hunger, 184:Medication 147:, certain 5372:Bilirubin 5322:Proteins 5300:Myoglobin 5098:Anion gap 5090:Acid-base 5038:Potassium 4974:Insulitis 4924:disorders 4882:Abnormal 4738:emerg/272 4733:eMedicine 4539:16 August 4533:study.com 4437:199047204 3904:16 August 3825:0141-8955 3782:199404906 3717:1061-4036 3659:2752-5457 3333:216594548 3270:115202581 3103:6 January 3098:0190-8286 3070:6 January 3043:16 August 3002:Vella A. 2962:1935-5548 2904:16 August 2661:cite book 2641:909025539 2595:cite book 1933:'blood'. 1902:The word 1898:Etymology 1847:metformin 1832:mortality 1824:per week. 1788:diazoxide 1773:diazoxide 1686:Diabetics 1651:diazoxide 1566:Education 1511:conscious 1488:Treatment 1431:C-peptide 1345:, called 1343:receptors 1285:carcinoid 1281:hepatomas 1261:C-peptide 1159:Briefly, 1098:C-peptide 963:Cytokines 959:Cytokines 836:Diabetics 540:Confusion 332:conscious 254:confusion 199:Frequency 172:Treatment 75:Specialty 5485:Proteins 5462:Azotemia 5394:Pancreas 5180:Hormones 5145:Ferritin 5043:Chloride 4814:Diabetes 4802:pancreas 4747:ped/1117 4744:med/1939 4741:med/1123 4462:Archived 4429:31402042 4389:32742108 4333:22258980 4240:Archived 4212:24052773 4156:Archived 4126:Archived 4104:30973639 4052:30973639 3988:Archived 3966:34429211 3958:19440117 3936:Medicine 3841:73436689 3833:30740739 3774:31376476 3735:21841779 3677:35118456 3620:10805172 3568:Archived 3564:29083820 3524:Archived 3520:31194450 3486:19088166 3442:52039366 3434:30121746 3399:26185599 3325:32343474 3262:30983138 3214:Archived 3210:25905350 3202:Endotext 3175:Archived 3171:30521262 3064:ABC News 3012:Archived 2970:33541857 2899:30521262 2864:Archived 2842:10681217 2834:25957977 2770:25685276 2706:Archived 2645:Archived 2579:Archived 2253:19088155 2033:Archived 1871:glinides 1828:per year 1816:glinides 1725:cortisol 1696:glinides 1667:Lucozade 1647:dextrose 1610:glucagon 1573:glucagon 1454:Insulin 1407:glinides 1363:glucagon 1359:neonates 1279:such as 1249:pancreas 1198:type III 1169:proteins 1139:cortisol 1115:glycogen 1062:glinides 955:cytokine 830:glucagon 814:glucagon 798:glinides 764:cortisol 733:glucagon 729:pancreas 702:Glycogen 698:glycogen 682:pancreas 671:Glucagon 667:pancreas 589:Sweating 553:Seizures 518:Headache 421:glucagon 336:glucagon 319:such as 274:seizures 262:sweating 250:headache 193:glucagon 133:glinides 92:seizures 87:Symptoms 5402:Amylase 5127:Lactate 5122:content 5048:Calcium 4922:Insulin 4692:D007003 4513:18 June 4380:7373113 4324:6486112 4203:3776519 4095:6459163 4043:6459163 3726:3163731 3668:8676101 3390:4499525 2761:4317315 1881:History 1867:insulin 1812:insulin 1810:taking 1692:insulin 1403:insulin 1257:insulin 1253:insulin 1213:organic 1202:type IV 1135:fasting 1058:insulin 1047:heparin 1007:lithium 1003:quinine 982:kidneys 971:kidneys 871:without 847:insulin 826:insulin 822:glucose 810:insulin 806:glucose 794:insulin 737:hormone 714:kidneys 708:in the 678:insulin 663:insulin 655:insulin 651:Glucose 604:anxiety 597:Tremors 530:fatigue 343:insulin 313:hormone 297:alcohol 285:insulin 189:Glucose 129:insulin 5407:Lipase 5033:Sodium 4886:levels 4830:type 2 4825:type 1 4821:Types 4727:000386 4611:KB60.4 4435: 4427: 4387: 4377: 4331: 4321: 4210: 4200: 4102: 4092: 4050: 4040: 3964: 3956: 3877: 3839: 3831: 3823: 3780: 3772: 3733: 3723: 3715: 3675: 3665: 3657: 3618: 3562: 3518: 3484: 3440: 3432: 3397: 3387: 3331: 3323: 3268: 3260: 3208: 3169: 3096: 2968: 2960: 2897: 2840: 2832: 2768: 2758: 2639: 2629: 2573: 2563: 2251: 1927:glykys 1861:, and 1277:tumors 1263:, and 1200:, and 1194:type I 1190:type 0 1064:, and 951:Sepsis 853:, and 828:, and 812:, and 800:, and 782:Causes 619:Nausea 610:Hunger 349:, and 317:tumors 301:sepsis 291:, and 207:Deaths 149:tumors 141:sepsis 121:Causes 5532:Other 4681:962.3 4677:775.6 4673:270.3 4669:251.2 4665:251.1 4661:251.0 4657:250.8 4642:E16.2 4638:E16.0 4433:S2CID 4243:(PDF) 4232:(PDF) 3962:S2CID 3837:S2CID 3778:S2CID 3438:S2CID 3329:S2CID 3301:(PDF) 3266:S2CID 2838:S2CID 1931:haima 1923:hypo- 1919:Greek 1873:, or 1818:, or 1775:, or 1763:, or 1755:with 1749:tumor 1698:, or 1529:Candy 1445:level 1439:level 1433:level 1409:, or 1241:tumor 1211:Some 1175:, or 997:drug 989:Drugs 978:liver 967:liver 710:liver 686:liver 659:liver 116:Rapid 107:death 5063:Urea 4869:See 4840:MODY 4804:and 4703:6431 4687:MeSH 4652:9-CM 4623:5A41 4619:8D8D 4615:5A45 4607:5A21 4541:2024 4515:2017 4470:2022 4425:PMID 4385:PMID 4329:PMID 4284:2019 4251:2021 4208:PMID 4164:2022 4134:2022 4100:PMID 4078:2019 4048:PMID 4026:2019 3996:2022 3954:PMID 3906:2024 3875:ISBN 3829:PMID 3821:ISSN 3770:PMID 3758:1864 3731:PMID 3713:ISSN 3673:PMID 3655:ISSN 3616:PMID 3576:2022 3560:PMID 3532:2022 3516:PMID 3482:PMID 3430:PMID 3395:PMID 3321:PMID 3258:PMID 3206:PMID 3183:2022 3167:PMID 3105:2024 3094:ISSN 3072:2024 3045:2024 3020:2022 2966:PMID 2958:ISSN 2906:2024 2895:PMID 2872:2019 2830:PMID 2766:PMID 2714:2022 2667:link 2653:2022 2637:OCLC 2627:ISBN 2601:link 2587:2022 2571:OCLC 2561:ISBN 2249:PMID 2041:2022 1653:and 1463:fast 1365:and 1299:The 1100:and 1033:and 969:and 915:fast 911:fast 875:with 774:and 766:and 755:and 735:, a 712:and 423:and 135:and 5493:LFT 5367:GGT 5355:AST 5350:ALT 5338:ALP 5240:HDL 5235:LDL 4648:ICD 4629:ICD 4598:ICD 4417:doi 4413:358 4375:PMC 4365:doi 4319:PMC 4311:doi 4198:PMC 4090:PMC 4082:doi 4038:PMC 4030:doi 3944:doi 3867:doi 3813:doi 3762:doi 3721:PMC 3705:doi 3663:PMC 3647:doi 3608:doi 3474:doi 3422:doi 3385:PMC 3375:doi 3313:doi 3250:doi 2950:doi 2860:FDA 2820:doi 2816:167 2756:PMC 2746:doi 2239:doi 1913:or 1906:is 1790:or 1743:or 1735:in 1727:in 1633:or 1092:or 1084:or 414:Age 369:or 227:or 139:), 5560:: 5118:CO 4756:: 4736:: 4725:: 4701:: 4690:: 4679:, 4675:, 4671:, 4667:, 4663:, 4659:, 4655:: 4636:: 4633:10 4621:, 4617:, 4613:, 4609:, 4605:: 4602:11 4571:. 4531:. 4501:. 4478:^ 4460:. 4456:. 4445:^ 4431:. 4423:. 4411:. 4397:^ 4383:. 4373:. 4361:12 4359:. 4355:. 4341:^ 4327:. 4317:. 4305:. 4301:. 4268:. 4238:. 4234:. 4220:^ 4206:. 4194:13 4192:. 4188:. 4172:^ 4154:. 4150:. 4124:. 4120:. 4098:. 4088:. 4076:. 4072:. 4060:^ 4046:. 4036:. 4024:. 4020:. 4004:^ 3986:. 3982:. 3960:. 3952:. 3940:88 3938:. 3934:. 3914:^ 3896:. 3873:, 3861:, 3849:^ 3835:. 3827:. 3819:. 3809:42 3807:. 3803:. 3776:. 3768:. 3756:. 3752:. 3729:. 3719:. 3711:. 3701:43 3699:. 3695:. 3671:. 3661:. 3653:. 3643:17 3641:. 3637:. 3614:. 3604:24 3602:. 3598:. 3584:^ 3566:. 3554:. 3540:^ 3522:. 3510:. 3494:^ 3480:. 3470:94 3468:. 3450:^ 3436:. 3428:. 3418:18 3416:. 3393:. 3383:. 3369:. 3365:. 3341:^ 3327:. 3319:. 3309:36 3307:. 3303:. 3278:^ 3264:. 3256:. 3246:11 3244:. 3222:^ 3212:. 3204:. 3173:. 3161:. 3113:^ 3088:. 3061:. 3036:. 3010:. 3006:. 2978:^ 2964:. 2956:. 2946:44 2944:. 2940:. 2921:. 2889:, 2858:. 2836:. 2828:. 2814:. 2810:. 2778:^ 2764:. 2754:. 2740:. 2736:. 2722:^ 2704:. 2700:. 2696:. 2675:^ 2663:}} 2659:{{ 2643:. 2635:. 2609:^ 2597:}} 2593:{{ 2577:. 2569:. 2261:^ 2247:. 2235:94 2233:. 2229:. 2049:^ 2031:. 2027:. 1945:^ 1869:, 1857:, 1853:, 1849:, 1814:, 1779:. 1771:, 1759:, 1694:, 1579:. 1484:. 1476:, 1405:, 1398:. 1259:, 1231:. 1208:. 1196:, 1192:, 1171:, 1104:. 1060:, 1053:. 849:, 832:. 824:, 808:, 796:, 747:. 716:. 692:. 345:, 311:, 307:, 303:, 287:, 272:, 260:, 256:, 191:, 151:, 143:, 131:, 105:, 5120:2 5008:e 5001:t 4994:v 4858:6 4855:5 4852:4 4849:3 4846:2 4843:1 4793:e 4786:t 4779:v 4650:- 4640:– 4631:- 4600:- 4590:D 4543:. 4517:. 4472:. 4439:. 4419:: 4391:. 4367:: 4335:. 4313:: 4307:1 4286:. 4253:. 4214:. 4166:. 4136:. 4106:. 4084:: 4054:. 4032:: 3998:. 3968:. 3946:: 3908:. 3869:: 3843:. 3815:: 3784:. 3764:: 3737:. 3707:: 3679:. 3649:: 3622:. 3610:: 3578:. 3534:. 3488:. 3476:: 3444:. 3424:: 3401:. 3377:: 3371:6 3335:. 3315:: 3272:. 3252:: 3185:. 3107:. 3074:. 3047:. 3022:. 2972:. 2952:: 2874:. 2844:. 2822:: 2772:. 2748:: 2742:6 2716:. 2669:) 2655:. 2603:) 2589:. 2255:. 2241:: 2043:. 1557:. 607:) 585:) 564:) 533:) 403:) 231:( 219:( 127:( 36:. 20:)

Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.

Index