What causes of recurrent hypoglycemia. H/o hypothyroidism.

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Recurrent hypoglycemia in a hypothyroid. 1)? Diabetic with very tight control of sugar, who is also into vigorous workout and weight reducing diet. 2)Addison's disease and hypothyroidism can co exist in Sheehan syndrome ( Pituitary apoplexy ) 3) Islet cell tumour of pancreas 4) Recreational use of anti diabetic drugs . Hypoglycemia ,like hypoxia, can give rise to orgasmic pleasure. ( Auto Erotic Asphyxiation ) 5) Certain drugs can enhance action of OHA and cause recurrent hypoglycemia- like sulphas . Beta blockers can cause hypoglycemic unawareness. 6 ) In a well controlled diabetic, onset of Nephropathy may be heralded by recurrent hypoglycemia. Damaged renal tissue is not able to destroy insulin , resulting in hyperinsulinemia and hypoglycemia.

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The main cause of recurrent hypoglycaemia,first exclude Diatebetes Mellitus, c impaired diet,drugs.after work up &stabilisation, other causes.... 1.Insulinoma, 2.Adrenal difiency 3.Pitutary difiency. Main tests r1.blood sugar 2.serum insulin3.C-Peptide level When blood sugar level<60 mg/dl Autonomic symptoms & <50 mg/dl....impaired Brain function 1.When blood sugar is <60 mg/dl,insulin level should be suprresed to <61.25 IU/ml 2.If normal or high insulin c C-Peptide—->it’s Exess Endogenous insulin production.

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Insulinoma Drug overdose Missed meals Exercise induced Reactive Impending diabetic nephropathy.

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