Curriculum · Metabolic and Endocrine and Diabetes Mellitus
Factitious hypoglycaemia from exogenous insulin
What it is
Factitious hypoglycemia is hypoglycemia secondary to exogenous insulin use. It matters because the clinical picture is that of insulinoma, an insulin-secreting pancreatic beta-cell tumor, and the two are told apart in the laboratory rather than at the bedside.
How it presents
The picture is recurrent attacks of symptomatic hypoglycemia in a patient without diabetes. Whipple triad holds the clinical features together: a low blood glucose level, signs or symptoms consistent with hypoglycemia, and relief of symptoms when blood glucose increases after treatment.