Hypoglycemia

Question 1

Processes

Answer 1

-Increased uptake by target cells by excess insulin
-Decreased insulin antagonists
-Decreased gluconeogenesis
Decreased glycogenolysis
-Increased glucose utilization without insulin stimulation

Question 2

Increased insulin secretion

Answer 2

-Pancreatic beta cell neoplasia (insulinoma)
-Xylitol toxicosis

Question 3

Decreased insulin antagonists

Answer 3

Hypoadrenocorticism (decreased cortisol and gluconeogenesis, increased sensitivity to insulin)

Question 4

Decreased gluconeogenesis

Answer 4

-Hepatic insufficiency/ failure (usually later)
-Hypoadrenocorticism
-Neonatal or juvenile hypoglycemia (not sufficient relative to need)
-Starvation

Question 5

Increased glucose utilization

Answer 5

Lactational hypoglycemia
Extreme leukocytosis and erythrocytosis

Question 6

Pathologic causes

Answer 6

Sepsis (especially endotoxemia) due to increased use by tissues and decreased production

Question 7

Pharmacologic hypoglycemia

Answer 7

-Insulin overdose
-Sulfonylurea compounds
-Ethanol

Question 8

In vitro hypoglycemia

Answer 8

-Serum not removed from clot
-Excess glycolysis from leukocytosis/thrombocytosis
-Br interference in iSTAT