Differentials

Idiopathic postprandial syndrome (pseudohypoglycaemia)

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Clinical history of hypoglycaemic symptoms after ingesting a carbohydrate-rich meal.

INVESTIGATIONS

Glucose level >3.3 mmol/L (>60 mg/dL) in presence of symptoms.

A 5-hour mixed meal test may also be used, although the sensitivity is poor.[44]

Insulin autoimmune hypoglycaemia

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Extremely rare condition that usually spontaneously resolves.

INVESTIGATIONS

Can assay for insulin antibodies as well as antibodies to insulin receptors.[44][45]

Diabetic hypoglycemia

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

History of diabetes mellitus. It is otherwise difficult to clinically distinguish diabetic hypoglycaemia from non-diabetic hypoglycaemia because the patient typically presents in a similar manner, with typical neuroglycopenic symptoms that improve quickly with administration of glucose.

INVESTIGATIONS

Oral glucose tolerance test: 2-hour plasma glucose ≥11.1 mmol/L (≥200 mg/dL) if diabetes mellitus.

Diabetic hypoglycaemia

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