List of causes of hypoglycemia explained

The following is a list of causes of hypoglycemia

Newborns

Hypoglycemia is a common problem with an increasing incidence in critically ill or extremely low birthweight infants.[1] Its potential association with brain damage and neurodevelopment delay make it an important topic. 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.[2]

Young children

Single episodes of hypoglycemia may occur due to gastroenteritis or fasting, but recurrent episodes nearly always indicate either an inborn error of metabolism, congenital hypopituitarism, or congenital hyperinsulinism. A list of common causes:

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.

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.

Causes by organ system

CardiovascularNo underlying causes
Chemical / poisoning1,1-Dichloroethene, Ackee fruit, Jamaican vomiting sickness, Systemic monochloroacetate poisoning
DermatologicNo underlying causes
Drug Side EffectAcetohexamide, 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
Ear Nose ThroatNo underlying causes
EndocrineAddison's disease, Adrenal insufficiency, Beginning stages of diabetes, Glucagon deficiency, Hypopituitarism, Hypothyroidism, Multiple endocrine neoplasia, Myxedema coma, Timme syndrome
EnvironmentalNo underlying causes
GastroenterologicAcute 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
Genetic2-methylbutyryl-coenzyme A dehydrogenase deficiency, 3-alpha-hydroxyacyl-CoA dehydrogenase deficiency, 3-Methylcrotonyl-CoA carboxylase deficiency, ACAD9 deficiency, Alpers' syndrome, Carbohydrate-deficient glycoprotein syndrome type 1b, Carnitine palmitoyltransferase I deficiency, Carnitine-acylcarnitine translocase deficiency, Cleft lip palate pituitary 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-diphosphatase deficiency, Fructose-1-phosphate aldolase deficiency, Galactose-1-phosphate uridyltransferase 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, Growth hormone deficiency (congenital), Hereditary ACTH resistance, HMG-CoA lyase deficiency, Hydroxymethylglutaryl-CoA lyase deficiency, Hyperinsulinism-hyperammonemia syndrome, Laron dwarfism, Leucine-induced hypoglycaemia, Liver glycogen synthase deficiency, Long-chain hydroxyacyl-CoA dehydrogenase 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, Navajo neurohepatopathy, Nephroblastomatosis-fetal ascites-macrosomia-wilms tumor, Nesidioblastosis, Plasma membrane carnitine transporter deficiency, Propionyl-CoA carboxylase deficiency PCCA type, Short-chain acyl-CoA dehydrogenase deficiency, Short stature-pituitary and cerebellar defects-small sella turcica, Triple A syndrome, Tyrosinaemia type 1, Very-long-chain acyl-CoA dehydrogenase deficiency, Wiedemann-Beckwith syndrome, X-linked congenital adrenal hypoplasia
HematologicHemolytic disease of the newborn
IatrogenicGastrojejunostomy, Postgastrectomy syndrome, Pyloroplasty, Reye syndrome
Infectious DiseaseAcute meningitis, Malaria (malignant tertian), Sepsis, Visceral leishmaniasis
Musculoskeletal / OrthoNo underlying causes
NeurologicAutonomic dystonia, Autonomic neuropathy, Elevated vagal tone
Nutritional / MetabolicCoenzyme Q cytochrome c reductase deficiency, Deficiency in enzymes of fat oxidation, Fructose intolerance, Galactosemia, Glycogen debranching deficiency, Hypoketonemic hypoglycemia, Ketotic hypoglycemia of infancy, Mcquarrie type infantile idiopathic hypoglycemia, Organic acidemia, Phosphoenolpyruvate carboxykinase (PEPCK) deficiency, Urea cycle disorder, Glucagon deficiency, ACAD9 deficiency, Dicarboxylicaminoaciduria, Fructose-1,6-diphosphatase deficiency, 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, Hydroxymethylglutaryl-CoA lyase deficiency, Long-chain hydroxyacyl-CoA dehydrogenase deficiency, Malonyl-CoA decarboxylase deficiency, Maple syrup urine disease, Medium chain acyl-CoA dehydrogenase deficiency, Methylmalonic acidemia, Nesidioblastosis, Propionyl-CoA carboxylase deficiency PCCA type, Short-chain acyl-CoA dehydrogenase deficiency, Tyrosinaemia type 1, Very-long-chain acyl-CoA dehydrogenase deficiency
Obstetric/GynecologicDiabetic mother, Gestational diabetes, Intrauterine growth retardation, Pregnancy, Premature labour and/or delivery, Sheehan syndrome
OncologicAdrenal cancer, Doege-Potter syndrome, IGF producing tumors, Tumors, Functioning pancreatic endocrine tumor, Insulinoma, Liver cancer, Mesothelioma
OphthalmologicNo underlying causes
Overdose / ToxicityAcetohexamide, Amprenavir, Chloramphenicol, Chlorpromazine, Chlorpropamide, Cibenzoline, Clove, Ethanol, Ethionamide, Fluorodeoxyglucose, Gatifloxacin, Ginseng, Glibenclamide, Gliclazide, Glimepiride, Glipizide, Gliquidone, Glisolamide, Glisoxepide, Insulin, Lanreotide, Levomepromazine, Mitiglinide, Nateglinide, Pazopanib, Pentamidine, Perazine, Pipothiazine, Pramlintide, Quinine, Repaglinide, Ritonavir, Saquinavir, Somatostatin, Sulfamethoxazole, Temafloxacin, Tolazamide, Tolbutamide, Trimethoprim
PsychiatricAnorexia nervosa, Bulimia nervosa, Munchausen syndrome
PulmonaryMesothelioma
Renal / ElectrolyteBenign glucosuria, Kidney Failure, Renal hypoglycemia, Uremia
Rheum / Immune / AllergyAutoimmune adrenalitis, Hemolytic disease of the newborn, Immunopathologic hypoglycemia, Insulin receptor antibodies
SexualNo underlying causes
TraumaBurns
UrologicNo underlying causes
DentalNo underlying causes
MiscellaneousAlcoholism, Binge drinking, Cachexia, Delayed separation blood sample, Drip arm sample, Fasting, Heavy exercise, Hypothermia, Idiopathic hypoglycemia, Septic shock, Starvation (acute)

Alphabetical order

References

  1. Edwards . Taygen . Liu . Gordon . Battin . Malcolm . Harris . Deborah L. . Hegarty . Joanne E. . Weston . Philip J. . Harding . Jane E. . 2022-03-18 . Oral dextrose gel for the treatment of hypoglycaemia in newborn infants . The Cochrane Database of Systematic Reviews . 2022 . 3 . CD011027 . 10.1002/14651858.CD011027.pub3 . 1469-493X . 8932405 . 35302645.
  2. Web site: WHO ref. number WHO/CHD/97.1 / WHO/MSM/97.1. 1997. Hypoglycaemia of the Newborn. World Health Organization. 4, 19. 6 April 2010. Geneva.
  3. H. Huopio1, S.-L. Shyng, T. Otonkoski3, and C. G. Nichols4. KATP channels and insulin secretion disorders. American Journal of Physiology. Endocrinology and Metabolism . Ajpendo.physiology.org . 2002-08-01 . 283 . 2 . E207–E216 . 10.1152/ajpendo.00047.2002 . 12110524 . 2012-03-10.
  4. Web site: Familial Leucine-Sensitive Hypoglycemia of Infancy Due to a Dominant Mutation of the β-Cell Sulfonylurea Receptor. Jcem.endojournals.org . 2004-09-01 . 2012-03-10.
  5. Web site: Umesh Masharani, MB, BS, MRCP(UK) . The Hypoglycemic states – Hypoglycemia . Armenian Medical Network . The Hypoglycemic states . 2007 .