How should we differentiate hypoglycaemia in non-diabetic patients?

Q3 Pharmacology, Toxicology and Pharmaceutics
Michele Modestino, Olimpia Iacono, Laura Ferrentino, Anna Lombardi, Umberto De Fortuna, Rita Verdoliva, M. De Luca, Vincenzo Guardasole
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引用次数: 0

Abstract

Hypoglycaemic syndromes are rare in apparently healthy individuals and their diagnosis can be a difficult challenge for clinicians as there are no shared guidelines that suggest how to approach patients with a suspect hypoglycaemic disorder. Since hypoglycaemia symptoms are common and nonspecific, it's necessary to document the Whipple Triad (signs and/or symptoms compatible with hypoglycaemia; relief of symptoms following glucose administration; low plasma glucose levels) before starting any procedure. Once the triad is documented, a meticulous anamnesis and laboratory tests (blood glucose, insulin, proinsulin, C-peptide, β-hydroxybutyrate and anti-insulin antibodies) should be performed. Results can guide the physician towards further specific tests, concerning the suspected disease. In this review, we consider all current causes of hypoglycaemia, including rare diseases such as nesidioblastosis and Hirata's syndrome, describe appropriate tests for diagnosis and suggest strategies to differentiate hypoglycaemia aetiology.
如何区分非糖尿病患者的低血糖症?
低血糖综合征在表面上健康的人身上并不多见,对临床医生来说,诊断低血糖综合征是一项艰巨的挑战,因为目前还没有共同的指南来指导如何处理疑似低血糖紊乱的患者。由于低血糖症状常见且无特异性,因此在开始任何程序之前,有必要记录惠普尔三联征(与低血糖相符的体征和/或症状;服用葡萄糖后症状缓解;低血浆葡萄糖水平)。一旦记录了三联征,就应进行细致的病史和实验室检查(血糖、胰岛素、胰岛素原、C 肽、β-羟丁酸和抗胰岛素抗体)。检查结果可指导医生针对疑似疾病进一步进行特定检查。在这篇综述中,我们考虑了目前导致低血糖的所有病因,包括罕见疾病,如内胚叶增生症和平田综合征,描述了用于诊断的适当检查,并提出了区分低血糖病因的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Basic and Clinical Physiology and Pharmacology
Journal of Basic and Clinical Physiology and Pharmacology Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
3.90
自引率
0.00%
发文量
53
期刊介绍: The Journal of Basic and Clinical Physiology and Pharmacology (JBCPP) is a peer-reviewed bi-monthly published journal in experimental medicine. JBCPP publishes novel research in the physiological and pharmacological sciences, including brain research; cardiovascular-pulmonary interactions; exercise; thermal control; haematology; immune response; inflammation; metabolism; oxidative stress; and phytotherapy. As the borders between physiology, pharmacology and biochemistry become increasingly blurred, we also welcome papers using cutting-edge techniques in cellular and/or molecular biology to link descriptive or behavioral studies with cellular and molecular mechanisms underlying the integrative processes. Topics: Behavior and Neuroprotection, Reproduction, Genotoxicity and Cytotoxicity, Vascular Conditions, Cardiovascular Function, Cardiovascular-Pulmonary Interactions, Oxidative Stress, Metabolism, Immune Response, Hematological Profile, Inflammation, Infection, Phytotherapy.
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