From the Guidelines
Hypoglycemia in non-diabetic individuals can be caused by various factors, including altered nutritional state, heart failure, renal or liver disease, malignancy, infection, or sepsis, as well as certain medications and medical conditions. According to a study published in Diabetes Care in 2015 1, patients with or without diabetes may experience hypoglycemia in the hospital setting due to these underlying conditions. Some key factors that can trigger hypoglycemia in non-diabetic individuals include:
- Altered nutritional state
- Heart failure
- Renal or liver disease
- Malignancy
- Infection or sepsis
- Sudden reduction of corticosteroid dose
- Reduced oral intake, emesis, or new NPO status
- Inappropriate timing of short- or rapid-acting insulin in relation to meals
- Reduced infusion rate of intravenous dextrose
- Unexpected interruption of enteral feedings or parenteral nutrition
It is essential to identify and address the underlying cause of hypoglycemia, as persistent hypoglycemia can have severe consequences on morbidity, mortality, and quality of life. As noted in the study 1, preventing hypoglycemia is crucial, especially in the hospital setting, where patients may be more vulnerable to these underlying conditions. Therefore, it is crucial to monitor patients closely for signs of hypoglycemia, especially those with underlying medical conditions, and to take prompt action to address the underlying cause.
From the Research
Causes of Hypoglycemia in Non-Diabetic Individuals
- Insulinoma, a rare tumor of the pancreas that produces excess insulin 2
- Non-islet cell tumor-induced hypoglycemia, such as liver cancer 2
- Insulin autoimmune syndrome, a condition in which the body produces antibodies against insulin 2
- Drug-induced hypoglycemia, such as methimazole 2
- Critical illnesses, such as viral hepatitis 2
- Hormone deficiencies, such as cortisol insufficiency 3, 4
- Non-islet cell tumors, such as liver cancer 3
- Accidental, surreptitious, or malicious hypoglycemia 3
- Endogenous hyperinsulinism, a condition in which the body produces too much insulin 3, 4
- Idiopathic postprandial hypoglycemia, a condition in which blood sugar drops after eating 3
- Genetic causes, such as monogenic congenital hyperinsulinism or inborn errors of metabolism (IEM) 4
- Paraneoplastic causes, such as Non-Islet-Cell Tumour Hypoglycemia (NICTH) 4
- Autoimmune causes, such as antibodies against insulin or the insulin receptor 4
- Alcohol use 5
- Comorbidity, such as a history of medication or self-medication 5
- Fasting or postprandial hypoglycemia, which can be related to various underlying causes 5, 4