Spontaneous Hypoglycaemia

Suspect in:

Patients with 'funny turns' relieved by glucose intake

Transient episodes of: blurred vision, tremulousness, sweating, palpitations, weakness and/or poor concentration

Symptoms occurring within 3h of food are unlikely to be serious.
NB - Fingerprick glucose assays are unhelpful as they are often inaccurate

Investigations

Plasma glucose, insulin and c-peptide (paired samples) x2 after 14hr fast, or when symptomatic

TFT

0900h Cortisol

LFT, U&E

Refer to Endocrine clinic if fasting hypoglycaemia is suspected.

Hospital Investigations

48h fast

NB The OGTT is of little value in investigating patients with possible hypoglycaemia.