Episode 47:

25 year old with hypoglycemia

Recurrent- she

CBG 40 to 55

50mg/dl

OCP

Whipples triad: sypmtoms consistent with hypoglycemia(shaky sweaty anxious

Low plasma glucose

Relieve of symptoms after intake of sugar

Why?

Insulin? Cbg fasting

Insulin, glu and c pepetide

Asymp

Regulation:

70-110(insulin) decrease when low sugar

Increase gluconeogenesis- increase sugar

Cpeptide from pro insulin( insulin high and c peptide low=exogenous insulin)(if both is high=
endogenous of use of sulfanileureas)

Obtain in hypoglycemic phase

POInt: facing a patient with hypoglycemia: 1 st it to demonstrate if there is realy hypoglycemia using the
whipples triad then draw labs (plasma glucose level, insulin levels, cpeptide drawed at symptomatic
episode
DKA