Broadening perspectives on hypoglycemia diagnosis in non-diabetic patients.

Mariola Méndez Muros, María Asunción Martínez-Brocca, Beatriz Rodríguez Jiménez, Ignacio Jiménez Varo, Fernando-Francisco Ortega Ortega, Félix Sánchez Fernández

Journal: Endocrinologia, diabetes y nutricion 2025;72(7):501599

PMID: 40750126

Full Text on Elsevier Science View on PubMed

Abstract

A 51-year-old man with a past medical history of chronic alcoholism was admitted for a planned fasting test due to suspected hypoglycemia. Despite previous evaluations by cardiology and neurology revealing no evident etiology, his syncopal episodes were suspected be associated with inconsistent hypoglycemic episodes. During his hospital admission, the patient experienced several syncopal episodes with associated seizures, which, at the time, were not related to hypoglycemia. This led to further investigation, including the exclusion of other causes, such as a possible autonomic dysfunction. Neurology consequently expanded the assessment, identifying subtle signs of mild parkinsonism and symptoms suggestive of a REM sleep disorder, which shifted the diagnostic suspicion. This case underscores the importance of considering other clinical conditions when evaluating hypoglycemia, especially when classic symptoms are absent or inconsistently presented, and an endocrinological origin has been ruled out.

Address: Servicio de Endocrinología y Nutrición, Hospital Virgen Macarena, Sevilla, Spain. Electronic address: [email protected].; Servicio de Endocrinología y Nutrición, Hospital Virgen Macarena, Sevilla, Spain.; Servicio de Neurología, Hospital Virgen Macarena, Seville, Spain.

DOI: 10.1016/j.endien.2025.501599

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MeSH Terms: Humans, Hypoglycemia, Male, Middle Aged, Syncope, Alcoholism, Seizures