Hypoglycemia: Strategies for laboratory investigation

Abstract

Hypoglycemia recently has become somewhat of a fad diagnosis, often misguidedly used to explain such vague complaints as chronic anxiety and lack of pep. True symptomatic hypoglycemia is of two types: reactive, which may follow gastric surgery, and fasting, most commonly associated with alcoholism, hepatic disease, pituitary or adrenal insufficiency, or tumor. Test strategies for documenting hypoglycemia, differentiating the two types, and identifying the cause are presented here.