The prevalence of factitious hypoglycaemia due to sulphonylurea abuse in the UK: A preliminary report

Teale, J D; Starkey, B.J.; Marks, Vincent; Hampton, Shelagh M.; Robinson, James R.; Fisher, Rory A.; Levine, David

doi:10.1002/pdi.1960060411

Cited by 24 publications

(13 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 Exogenous insulin administration is easily identified because of the concomitant suppression of C peptide. However, sulphonylurea misuse may mimic insulinoma because of the associated high insulin and C peptide concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…In a series of 151 cases investigated for spontaneous hypoglycaemia 5.3% of plasma samples submitted for insulin assay contained detectable concentrations of sulphonylurea drugs. 2 Patients with insulinoma often have raised proinsulin concentrations, but this feature is not diagnostic 2 3 and cannot exclude hypoglycaemia induced by sulphonylurea.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

ABC of clinical haematology: The hereditary anaemias

Weatherall¹

1997

BMJ

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

ABC of clinical haematology: The hereditary anaemias

Weatherall¹

1997

BMJ

View full text Add to dashboard Cite

“…This anomaly occurs only very rarely in other disorders, most notably PHHI or 'nesidioblastosis' and sulphonylurea overdose (Teale et al 1989).…”

Section: Chemical Pathologymentioning

confidence: 99%

Tumours producing hypoglycaemia

Teale¹

1998

Endocrine Related Cancer

Self Cite

View full text Add to dashboard Cite

“…Hyperinsulinaemic hypoglycaemic, however, can occur spontaneously without a stressful stimulus and characteristically presents most commonly during the ®rst post-natal weeks as a result of dysregulation of insulin secretion [3]. Hyperinsulinaemic hypoglycaemia can also be induced pharmacologically, either intentionally as a diagnostic tool, accidentally as a complication of the treatment of diabetes mellitus, or as a consequence of poisoning either with insulin itself [4], or with drugs such as sulphonylureas which stimulate insulin release [11]. Non-accidental poisoning as a form of child abuse was ®rst recognised by Kempe et al [5].…”

mentioning

confidence: 97%

A child presenting with disordered consciousness, hallucinations, screaming episodes and abdominal pain

Hussain¹,

Mundy²,

Aynsley-Green³

et al. 2002

European Journal of Pediatrics

View full text Add to dashboard Cite

A previously well 2-year-old child presented to an Accident and Emergency department at 3.30 in the morning with disordered consciousness, hallucinations, screaming episodes and abdominal pain. She was seen by the paediatric team and thought to have an intussusception and thus was referred to a regional paediatric surgical unit at another hospital. During this initial assessment no measurement of blood glucose level was made. Four hours later she was reviewed by the surgical team and an intussusception was excluded on clinical and radiological grounds. She was then referred on to the paediatric medical team within the same hospital. At this time she was still hallucinating but otherwise her examination was unremarkable. The child's mother was questioned about any medications that the child might have been exposed to, but mentioned only the possibility of rat poison. A urine specimen was sent for toxicology. Only during this third assessment was a blood sample drawn for measurement of blood glucose by a reagent strip with a glucometer (BM Stix) and the child noted to be profoundly hypoglycaemic with a BM Stix reading of 0.8 mmol/l (14 mg/dl). The result was not con®rmed by laboratory measurement. She was treated with a bolus of 10% dextrose given intravenously and two subsequent BM Stix readings showed values of 6.1 mmol/l (100 mg/dl) and 6.4 mmol/l (115 mg/dl). Her full blood count, routine chemistry, and capillary blood gas values were normal. Her urine did not show the presence of any ketone bodies. She was subjected to an EEG, (which did not suggest any epileptiform activity) and a CT scan of her brain, which was normal.Sixteen hours after her admission she became unresponsive, began convulsing and was unable to maintain her airway. She required intubation and ventilation and transfer to a paediatric intensive care unit was arranged. Her blood glucose value on the blood gas printout was 1.4 mmol/l (25 mg/dl). She was treated with a further bolus of 50% dextrose. After transfer and initial stabilisation, her glucose requirement was calculated to be 14.5 mg/kg per min in order to maintain a blood glucose concentration >2.6 mmol/l (normal glucose requirements for her age 4±6 mg/kg per min). Despite continuous intravenous infusion of glucose she had two further hypoglycaemic episodes and appropriate endocrine and metabolic blood samples were taken at the time of the hypoglycaemia (Table1). These further two episodes of hypoglycaemia may have been due to the miscalculation of glucose requirements as there was confusion about the percentage of dextrose being infused and the glucose requirements in mg/kg per min. This resulted in the child receiving less glucose than required to maintain normoglycaemia. Urine and blood specimens were sent for routine toxicology. She was extubated after 24 h with no complications and subsequently transferred to another tertiary centre for further assessment of the cause of the hypoglycaemia.At this centre, speci®c questioning revealed a family history of non-insulin dependent diabetes...

show abstract

The prevalence of factitious hypoglycaemia due to sulphonylurea abuse in the UK: A preliminary report

Cited by 24 publications

References 6 publications

ABC of clinical haematology: The hereditary anaemias

ABC of clinical haematology: The hereditary anaemias

Tumours producing hypoglycaemia

A child presenting with disordered consciousness, hallucinations, screaming episodes and abdominal pain

Contact Info

Product

Resources

About