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Hypoglycemia in non-diabetic in-patients at a teaching referral hospital in Iran.

J Diabetes Metab Disord

June 2024

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Article Synopsis
  • This study examined non-diabetic patients with hypoglycemia to understand their comorbid conditions, symptoms, lab results, and diagnoses.
  • Conducted at Shariati Hospital in Iran from 2016 to 2023, it analyzed data from 74 non-diabetic patients, excluding those with diabetes and focusing on various factors related to their hypoglycemic episodes.
  • The findings revealed that a significant portion experienced common symptoms like weakness and dizziness, with underlying causes including psychological disorders and organ failure, highlighting the need for timely diagnosis and treatment to avoid serious health consequences.
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Article Synopsis
  • Hypoglycaemia in diabetes involves abnormal glucose levels accompanied by symptoms, while Munchausen Syndrome (MS) entails individuals intentionally faking symptoms for secondary gain.
  • The report discusses a case of a 28-year-old woman with type I diabetes who repeatedly induced hypoglycemia attacks to seek unnecessary medical attention.
  • Understanding Munchausen Syndrome is crucial for healthcare providers to avoid misdiagnosing patients and to prevent costly and unnecessary medical procedures.
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Article Synopsis
  • Severe insulin resistance is characterized by an insulin requirement over 2 units per kg of body weight and is uncommon in diabetics.
  • Common causes include severe insulin resistance syndromes, medications, endocrine disorders, and other factors, while the specific case described involved pseudo-resistance due to improper insulin use.
  • Proper assessment is essential for patients needing high doses of insulin to rule out issues like injection technique, medication adherence, or storage problems.
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Misinterpretation of common endocrine hormonal immunoassays can distort the clinical picture and lead to unnecessary medical workups. Potential assay inference is important to recognize when the clinical presentation and laboratory evaluation are inconsistent. This is demonstrated by the case of an 18-month-old girl who initially presented with ketotic hypoglycemia and was found on diagnostic fasting evaluation to have the triad of hypoglycemia, inappropriately high insulin levels, and low C-peptide levels-point-of-care glucose 43 mg/dL (2.

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Diabetes is the leading cause of end-stage kidney disease (ESKD), accounting for approximately 50% of patients starting dialysis. However, the management of these patients at the stage of chronic kidney disease (CKD) remains poor, with fragmented care pathways among healthcare professionals (HCPs). Diagnosis of CKD and most of its complications is based on laboratory evidence.

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