Evaluation in patients without diabetes- but have hypoglycemia

(JCEM 2009;94:709)

• If clinically ill: take measures to avoid recurrent hypoglycemia; ✓ BUN, Cr, LFTs, TFTs, prealbumin; IGF-I/IGF-II ratio when appropriate
• If otherwise healthy: 72-h fast w/ monitored blood glc; stop for neuroglycopenic sx
• At time of hypoglycemia: insulin, C peptide (↑ w/ insulinoma and sulfonylureas, ↓ w/ exogenous insulin), β-OH-butyrate, sulfonylurea levels
• At end of fast, give 1 mg glucagon IV and measure response of plasma glc before feeding