Intentional hypoglycaemia in diabetic patients treated with insulin
Abstract
Introduction: Hypoglycaemia is the significant limiting factor in management of diabetes. It causes a recurrent morbidity and impairs quality of life in most patients, especially those with Type 1 diabetes. Non-iatrogenic hypoglycaemia in a diabetic patient presents a difficult diagnostic challenge. It could be a consequences of deliberately use of insulin or insulin secretegogues (factitious hypoglycaemia, malingering) or organic diseases (insulinoma).
Cases report: Two diabetic patients with surreptitious episodes of hypoglycaemia due to intentional application of insulin are described. This condition has to be suspected in unexplained recurrent episodes of hypoglycaemia. In these cases determination of C-peptide and insulin levels should be considered prior to other more invasive and expensive diagnostic procedures
Conclusions: The authors believe that early and correct diagnosis of intentional hypoglycaemia prevents unnecessary diagnostic and therapeutic procedures as well as possible morbidity and mortality. The aim of the present report is to remind the medical personnel, especially in the emergency departments, of this often overlooked condition.
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