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Importance of Insulin Immunoassays in the Diagnosis of Factitious Hypoglycemia

We report two cases emphasizing the importance of insulin assays for evaluation of hypoglycemia in diabetic patients. Case 1 was a 96/12-year-old female patient with type 1 diabetes mellitus and case 2 was a 1010/12-year-old male patient with DIDMOAD. Both patients were on a basal-bolus insulin regi...

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Autores principales: Nalbantoğlu Elmas, Özlem, Demir, Korcan, Soylu, Nusret, Çelik, Nilüfer, Özkan, Behzat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293663/
https://www.ncbi.nlm.nih.gov/pubmed/25541899
http://dx.doi.org/10.4274/jcrpe.1492
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author Nalbantoğlu Elmas, Özlem
Demir, Korcan
Soylu, Nusret
Çelik, Nilüfer
Özkan, Behzat
author_facet Nalbantoğlu Elmas, Özlem
Demir, Korcan
Soylu, Nusret
Çelik, Nilüfer
Özkan, Behzat
author_sort Nalbantoğlu Elmas, Özlem
collection PubMed
description We report two cases emphasizing the importance of insulin assays for evaluation of hypoglycemia in diabetic patients. Case 1 was a 96/12-year-old female patient with type 1 diabetes mellitus and case 2 was a 1010/12-year-old male patient with DIDMOAD. Both patients were on a basal-bolus insulin regimen. Both were admitted because of persistent hypoglycemia. Analyses of serum samples obtained at the time of hypoglycemia initially showed low insulin and C-peptide levels. Recurrent episodes of unexplained hypoglycemia necessitated measurement of insulin levels by using different insulin assays, which revealed hyperinsulinemic hypoglycemia with low C-peptide levels, findings which confirmed a diagnosis of factitious hypoglycemia. Surreptitious administration of insulin should not be excluded in diabetic patients with hypoglycemia without taking into account the rate of cross-reactivity of insulin analogues with the insulin assay used.
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spelling pubmed-42936632015-01-30 Importance of Insulin Immunoassays in the Diagnosis of Factitious Hypoglycemia Nalbantoğlu Elmas, Özlem Demir, Korcan Soylu, Nusret Çelik, Nilüfer Özkan, Behzat J Clin Res Pediatr Endocrinol Case Report We report two cases emphasizing the importance of insulin assays for evaluation of hypoglycemia in diabetic patients. Case 1 was a 96/12-year-old female patient with type 1 diabetes mellitus and case 2 was a 1010/12-year-old male patient with DIDMOAD. Both patients were on a basal-bolus insulin regimen. Both were admitted because of persistent hypoglycemia. Analyses of serum samples obtained at the time of hypoglycemia initially showed low insulin and C-peptide levels. Recurrent episodes of unexplained hypoglycemia necessitated measurement of insulin levels by using different insulin assays, which revealed hyperinsulinemic hypoglycemia with low C-peptide levels, findings which confirmed a diagnosis of factitious hypoglycemia. Surreptitious administration of insulin should not be excluded in diabetic patients with hypoglycemia without taking into account the rate of cross-reactivity of insulin analogues with the insulin assay used. Galenos Publishing 2014-12 2014-12-05 /pmc/articles/PMC4293663/ /pubmed/25541899 http://dx.doi.org/10.4274/jcrpe.1492 Text en © Journal of Clinical Research in Pediatric Endocrinology, Published by Galenos Publishing. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Nalbantoğlu Elmas, Özlem
Demir, Korcan
Soylu, Nusret
Çelik, Nilüfer
Özkan, Behzat
Importance of Insulin Immunoassays in the Diagnosis of Factitious Hypoglycemia
title Importance of Insulin Immunoassays in the Diagnosis of Factitious Hypoglycemia
title_full Importance of Insulin Immunoassays in the Diagnosis of Factitious Hypoglycemia
title_fullStr Importance of Insulin Immunoassays in the Diagnosis of Factitious Hypoglycemia
title_full_unstemmed Importance of Insulin Immunoassays in the Diagnosis of Factitious Hypoglycemia
title_short Importance of Insulin Immunoassays in the Diagnosis of Factitious Hypoglycemia
title_sort importance of insulin immunoassays in the diagnosis of factitious hypoglycemia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293663/
https://www.ncbi.nlm.nih.gov/pubmed/25541899
http://dx.doi.org/10.4274/jcrpe.1492
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