258. Hypoglycaemia and Insulinomas

Question 1

Describe hypoglycaemia?

Answer 1

Blood glucose<3mmol/L

Sweating, anxiety, hunger, tremor, palpitations

Confusion, coma, seizures, mutism

Question 2

What are the causes of hypoglycaemia?

Answer 2

EX- ogenous drugs e.g. insulin, sulynureas, alcohol, aspirin, ace i, b blockers

P-ituitary insufficiency
L- iver failure
A- ddison's
I- slet cell tumours
N-on pancreatic neoplasms

Question 3

What is an insulinoma?

Answer 3

Fasting hypo with whipple’s triad

Symptoms of fasting/exercise
Recorded hypo with symptoms
Relieved with glucose

Question 4

How can you test for an insulinoma?

Answer 4

screening- hypoglycaemia + v high plasma insulin after fast

Give IV insulin and measure c peptide. Insulin should suppress C peptide but not in insulinoma.