Hypoglycaemia factitia
| Classification according to ICD-10 | |
|---|---|
| E16.0 | Drug-induced hypoglycemia without coma |
| F68.1 | Artificial disorder (deliberately creating or feigning physical or psychological symptoms or disabilities) |
| ICD-10 online (WHO version 2019) | |
The hypoglycaemia factitia is a disease, which is targeted by self-administration of hypoglycemic agents to an intentional lowering of blood glucose is.
diagnosis
The diagnostic - albeit difficult to detect - criterion is the deliberate cause of the lowering of blood sugar by the patient . Patients provoke low blood sugar levels by taking blood sugar-lowering drugs (mainly sulfonylureas ) or by self-administered insulin . In the context of Munchausen syndrome , medical attention and hospital stays can be enforced.
- Sulphonylurea breakdown products can be detected in the urine or serum .
- Injection sites for the insulin can be hidden so that they escape examination. Detection in the blood is only possible indirectly. Insulin preparations do not contain a C-peptide . Therefore, in insulin-induced hypoglycaemia factitia, the insulin but not the C-peptide level is increased. In parallel to the C-peptide, blood sugar and insulin levels in the blood must be determined.
The clinical picture is found more frequently in women who are employed in the healthcare sector.
Differential diagnosis
- Hypoglycaemia factitia is an important differential diagnosis in all hypoglycaemia that occurs in diabetics and non-diabetics.
- Hypoglycaemia can occur as part of the therapy of diabetes mellitus with drugs that lower blood sugar .
- A disease that can lead to hypoglycaemia is the insulinoma , an insulin-producing tumor that can be easily detected in a laboratory.
Individual evidence
- ^ Institute for Clinical Chemistry at the University Hospital Cologne - last update: April 28, 2010.
- ↑ Insulin-induced hypoglycaemia factitia for dietary reasons - Last updated: March 29, 2015.
literature
- FJ Service: Hypoglycemic disorders. In: N Engl J Med. 1995 Apr 27; 332 (17), pp. 1144-1152. ( Link )
- R. Charlton, G. Smith, Day A: Munchausen's syndrome manifesting as factitious hypoglycemia. In: Diabetologia . 2001; 44, pp. 784-785.
