We concluded that this patient had factitious hypoglycemia, a syndrome where patients self-induce hypoglycemia to seek medical attention or assume a sick role.
Factitious hypoglycemia is highly challenging to diagnose and manage.
Measurement of C-peptide and free and direct insulin can help differentiate factitious hypoglycemia from other organic causes.
The differential diagnoses of hyperinsulinemic hypoglycemia include familial persistent hyperinsulinemic hypoglycemia, primary islet-cell hyperplasia, noninsulinoma pancreatogenous hypoglycemic syndrome, insulinoma, and
factitious hypoglycemia (6).
Presumed to be rare,
factitious hypoglycemia is most often seen in people without diabetes who are healthcare workers, relatives of diabetes patients, and often women.
To introduce the CE method as a confirmatory method for SU identification in the cases of factitious hypoglycemia, we tried to optimize the preanalytical phase by replacing the classical liquid-liquid extraction with a solid-phase extraction (22).
Factitious hypoglycemia due to surreptitious administration of insulin: diagnosis, treatment and long-term follow-up.
Sulfonylurea-induced factitious hypoglycemia in a non-diabetic nurse.
