Hypoglycemia Differential Etiology
The differential diagnosis for hypoglycemia can be organized into the following categories:
- Single Most Likely Diagnosis
- Diabetes medication (e.g., insulin, sulfonylureas): This is the most common cause of hypoglycemia, especially in patients with diabetes who are taking medications that increase insulin levels or enhance its effects.
- Other Likely Diagnoses
- Insulinoma: A rare tumor of the pancreas that produces excess insulin, leading to hypoglycemia.
- Adrenal insufficiency: A condition where the adrenal glands do not produce enough cortisol and aldosterone, which can lead to hypoglycemia.
- Pituitary insufficiency: A condition where the pituitary gland does not produce enough hormones, including ACTH, which can lead to hypoglycemia.
- Severe malnutrition or starvation: Prolonged fasting or severe malnutrition can lead to hypoglycemia due to depleted glucose stores.
- Excessive alcohol consumption: Alcohol can cause hypoglycemia by inhibiting glucose production in the liver.
- Do Not Miss Diagnoses
- Septic shock: Severe infections can cause hypoglycemia due to increased glucose consumption by the body.
- Hepatic failure: Liver dysfunction can lead to hypoglycemia due to impaired glucose production.
- Cardiac arrest: Hypoglycemia can be a cause of cardiac arrest, and prompt recognition and treatment are crucial.
- Meningoencephalitis: Inflammation of the brain and meninges can cause hypoglycemia due to increased glucose consumption.
- Rare Diagnoses
- Gastrinoma: A rare tumor that produces excess gastrin, leading to increased insulin secretion and hypoglycemia.
- Glucagonoma: A rare tumor that produces excess glucagon, which can lead to hypoglycemia due to increased glucose consumption.
- Lactic acidosis: A rare condition characterized by elevated lactic acid levels, which can cause hypoglycemia.
- Congenital hyperinsulinism: A rare genetic disorder that causes excessive insulin production, leading to hypoglycemia.
- Factitious hypoglycemia: Self-induced hypoglycemia, often seen in patients with a history of factitious disorder.