Hypoglycemia causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Causes

Life Threatening Causes
Common Causes
Causes by Organ System
Cardiovascular No underlying causes
Chemical / poisoning 1,1-Dichloroethene, clove, ethanol, ginsen, jamaican vomiting sickness, systemic monochloroacetate poisoning
Dermatologic No underlying causes
Drug Side Effect Acetohexamide, amprenavir, chloramphenicol, chlorpromazine, chlorpropamide, cidofovir, cibenzoline, dipeptidyl peptidase-4 inhibitor, empagliflozin, ethanol, ethionamide, fluorodeoxyglucose, gatifloxacin, ginseng, glibenclamide, gliclazide, glimepiride, glipizide, gliquidone, glisolamide, glisoxepide, glyburide, insulin aspart, insulin detemir, insulin glargine, insulin-like growth factor, lanreotide, levomepromazine, levobunolol hydrochloride, linagliptin, lorcaserin, mecasermin, meropenem, mitiglinide, nateglinide, nitisinone, oxcarbazepine, pazopanib, pegvisomant, penicillamine, pentamidine isethionate, perazine, pipothiazine, pramipexole, pramlintide, quinine, repaglinide, rifaximin, ritonavir, saxagliptin, saquinavir, sertraline, somatostatin, sulfamethoxazole, temafloxacin, thalidomide, tolazamide, tolbutamide, trimethoprim, vildagliptin, zonisamide
Ear Nose Throat No underlying causes
Endocrine Addison's disease, ACTH deficiency, adrenal cancer, adrenal cortex insufficiency, adrenal insufficiency, autoimmune adrenalitis, congenital hyperinsulinism, diabetes mellitus type 1, diabetes mellitus type 2, diabetic gastroparesis, functioning pancreatic endocrine tumor, glucocorticoid deficiency 1, growth hormone deficiency, hyperinsulinism, hyperinsulinism due to glutamodehydrogenase deficiency,hypopituitarism, hypoglycemia, hypothyroidism, hypopituitarism, islet cell adenoma, insulin, insulinoma, idiopathic growth hormone deficiency, ketotic hypoglycemia, multiple endocrine neoplasia type 1, myxedema coma, nesidioblastosis, pancreatic cancer, sheehan's syndrome, timme syndrome, tyrosinemia, Wilms tumor
Environmental No underlying causes
Gastroenterologic Acute fatty liver of pregnancy, acute liver failure, cirrhosis, diabetic gastroparesis, diarrhea, dumping syndrome, functioning pancreatic endocrine tumor, gastric dumping syndrome, hepatic congestion, hepatic failure, idiopathic postprandial syndrome, Insulinoma, liver cancer, malabsorption, maldigestion, reactive hypoglycemia, severe hepatitis
Genetic 2-methylbutyryl-coenzyme A dehydrogenase deficiency, 3-alpha-hydroxyacyl-CoA dehydrogenase deficiency, 3-Methylcrotonyl-CoA carboxylase deficiency, ACAD9 deficiency, adrenal hypoplasia congenital, X-linked, acetohexamide, aldolase A deficiency, alpers syndrome, Beckwith-Weidemann Syndrome carbohydrate-deficient glycoprotein syndrome type 1b, carnitine palmitoyltransferase 1 deficiency, carnitine-acylcarnitine translocase deficiency, Coenzyme Q cytochrome c reductase deficiency, cleft lip palate pituitary deficiency, debrancher deficiency, dicarboxylicaminoaciduria, dihydrolipoamide dehydrogenase deficiency, Donohue syndrome, dopamine beta hydroxylase deficiency, familial glucocorticoid deficiency, familial hyperinsulinemic hypoglycemia type 3, familial hyperinsulinemic hypoglycemia type 5, familial hyperinsulinemic hypoglycemia type 7, fructose-1,6-bisphosphatase deficiency, fructose-1-phosphate aldolase deficiency, galactose-1-phosphate uridyltransferase deficiency, glucose 6 phosphate dehydrogenase deficiency, glutaric acidemia type 2, glucokinase mutations, glycogenosis type 1a, glycogenosis type 1b, glycogenosis type 3, glycogenosis type 6, glycogenosis type 9a, glycogenosis type 9b, glycogenosis type 9c, glycogenosis type V, growth hormone deficiency, hereditary ACTH resistance, hepatocyte nuclear factor 1a, HMG-CoA lyase deficiency, hydroxymethylglutaryl-CoA lyase deficiency, hyperinsulinism-hyperammonemia syndrome, KATP channel defects, Laron dwarfism, leucine-induced hypoglycaemia, liver glycogen synthase deficiency, malonyl-CoA decarboxylase deficiency, maple syrup urine disease, medium chain acyl-CoA dehydrogenase deficiency, methylmalonic acidemia, mitochondrial DNA depletion syndrome, hepatocerebral form, mitochondrial trifunctional protein deficiency, monocarboxylate transporter 1, navajo neurohepatopathy, nesidioblastosis, paternal uniparental disomy, Plasma membrane carnitine transporter deficiency, Propionyl-CoA carboxylase deficiency PCCA type, propionic acidemia, primary carnitine deficiency, pyruvate carboxylase deficiency, Short chain acyl-CoA dehydrogenase deficiency, triple A syndrome, tyrosinaemia type 1, uncoupling protein 2, very long-chain acyl-CoA dehydrogenase deficiency, septic shock
Hematologic Hemolytic disease of the newborn
Iatrogenic Gastrojejunostomy, gastric dumping syndrome, postgastrectomy syndrome, pyloroplasty, Reye syndrome
Infectious Disease Acute meningitis, malaria, neonatal bacterial meningitis, Reye's syndrome, sepsis, visceral leishmaniasis
Musculoskeletal / Ortho No underlying causes
Neurologic Acute meningitis, autonomic dystonia, autonomic neuropathy, elevated vagal tone, Reye's syndrome
Nutritional / Metabolic Acetohexamide, ACAD9 deficiency, binge drinking, coenzyme Q cytochrome c reductase deficiency, deficiency in enzymes of fat oxidation, diabetic gastroparesis, dicarboxylic aminoaciduria, fructose intolerance, galactosemia, glycogen debranching deficiency, glucose-6-phosphatase deficiency, hypoketonemic hypoglycemia, Ketotic hypoglycemia of infancy, Mcquarrie type infantile idiopathic hypoglycemia, organic acidemia, pyruvate carboxylase deficiency, phosphoenolpyruvate carboxykinase (PEPCK) deficiency, urea cycle disorder, glucagon deficiency, fructose-1, 6-diphosphatase deficiency, fructose intolerance, Fructose-1,6-bisphosphatase deficiency, hereditary, galactosemia,fructose-1-phosphate aldolase deficiency, glucose 6 phosphate dehydrogenase deficiency, glutaric acidemia type 2, glycogenosis type 1a, glycogenosis type 1b, glycogenosis type 3, glycogenosis type 6, glycogenosis type 9a, glycogenosis type 9b, glycogenosis type 9c, glycogenosis type V, HMG-CoA lyase deficiency, HMG CoA synthetase deficiency,hydroxymethylglutaryl-CoA lyase deficiency, inborn urea cycle disorder, leucinosis, long chain hydroxyacyl-CoA dehydrogenase deficiency, malabsorption, malonic aciduria,malonyl-CoA decarboxylase deficiency, maple syrup urine disease, medium chain acyl-CoA dehydrogenase deficiency, methylmalonic acidemia, nesidioblastosis, organic acidemia, propionic acidemia, propionyl-CoA carboxylase deficiency PCCA type, reactive hypoglycemia, short chain acyl-CoA dehydrogenase deficiency, tyrosinaemia type 1, very long-chain acyl-CoA dehydrogenase deficiency
Obstetric/Gynecologic Diabetic mother, gestational diabetes, intrauterine growth retardation, pregnancy, premature labour and/or delivery, sheehan syndrome, acute fatty liver of pregnancy,hemolytic disease of the newborn
Oncologic Adrenal cancer, breast cancer, Doege-potter syndrome, IGF producing tumors, tumors, pancreatic cancer, insulinoma, liver cancer, mesothelioma, metastatic insulinoma
Opthalmologic No underlying causes
Overdose / Toxicity Acetohexamide, amprenavir, chloramphenicol, chlorpromazine, chlorpropamide, cibenzoline, clove, ethanol, ethionamide, fluorodeoxyglucose, gatifloxacin, ginseng, glibenclamide, gliclazide, glimepiride, glipizide, gliquidone, glisolamide, glisoxepide, insulin, insulin like growth factor , lanreotide, levomepromazine, mitiglinide, nateglinide, pazopanib, pentamidine, perazine, pipothiazine, pramlintide, quinine, repaglinide, ritonavir, saquinavir, somatostatin, sulfamethoxazole, temafloxacin, tolazamide, tolbutamide, trimethoprim
Psychiatric Anorexia nervosa, bulimia nervosa, Munchausen syndrome, factitious hypoglycemia
Pulmonary Mesothelioma
Renal / Electrolyte Benign glucosuria, renal failure, renal hypoglycemia, uremia
Rheum / Immune / Allergy Autoimmune adrenalitis, hemolytic disease of the newborn, immunopathologic hypoglycemia, insulin receptor antibodies
Sexual No underlying causes
Trauma Burns
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Alcoholism, binge drinking, burns, cachexia, chronic hypoglycemia, delayed separation blood sample, drip arm sample, fasting, heavy exercise, hepatic failure, hypothermia, idiopathic hypoglycemia, insulin shock, malnutrition, Mcquarrie type infantile idiopathic hypoglycemia, pregnancy, sepsis, starvation, strenuous exercise, shock
Causes in Alphabetical Order

Causes

Common Causes

Hypoglycemia in Newborn Infants

Hypoglycemia is a common problem in critically ill or extremely low birthweight infants. If not due to maternal hyperglycemia, in most cases it is multifactorial, transient and easily supported. In a minority of cases hypoglycemia turns out to be due to significant hyperinsulinism, hypopituitarism or an inborn error of metabolism and presents more of a management challenge.

Hypoglycemia in Young Children

Single episodes of hypoglycemia due to gastroenteritis or fasting, but recurrent episodes nearly always indicate either an inborn error of metabolism, congenital hypopituitarism, or congenital hyperinsulinism

Hypoglycemia in Older Children and Young Adults

By far the most common cause of severe hypoglycemia in this age range is insulin injected for type 1 diabetes. Circumstances should provide clues fairly quickly for the new diseases causing severe hypoglycemia. All of the congenital metabolic defects, congenital forms of hyperinsulinism, and congenital hypopituitarism are likely to have already been diagnosed or are unlikely to start causing new hypoglycemia at this age. Body mass is large enough to make starvation hypoglycemia and idiopathic ketotic hypoglycemia quite uncommon. Recurrent mild hypoglycemia may fit a reactive hypoglycemia pattern, but this is also the peak age for idiopathic postprandial syndrome, and recurrent "spells" in this age group can be traced to orthostatic hypotension or hyperventilation as often as demonstrable hypoglycemia.

Hypoglycemia in Older Adults

The incidence of hypoglycemia due to complex drug interactions, especially involving oral hypoglycemic agents and insulin for diabetes rises with age. Though much rarer, the incidence of insulin-producing tumors also rises with advancing age. Most tumors causing hypoglycemia by mechanisms other than insulin excess occur in adults.

References

  1. ↑ "The Hypoglycemic states - Hypoglycemia". The Hypoglycemic states. Armenian Medical Network. 2007. Text " Umesh Masharani, MB, BS, MRCP(UK) " ignored (help)


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