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. 2022 Nov;5(6):e375.
doi: 10.1002/edm2.375. Epub 2022 Sep 18.

Prevalence and characteristics of factitious hypoglycaemia in non-diabetic patients in a department of endocrinology

Ibtissem Oueslati  1 , Amani Terzi  1 , Meriem Yazidi  1 , Elyes Kamoun  1 , Melika Chihaoui  1
Affiliations

Prevalence and characteristics of factitious hypoglycaemia in non-diabetic patients in a department of endocrinology

Ibtissem Oueslati et al. Endocrinol Diabetes Metab. 2022 Nov.

Abstract

Introduction: Factitious hypoglycaemia is defined as the surreptitious use of insulin or oral hypoglycaemic agents to deliberately induce self-harm. It represents a challenging diagnosis and misdiagnosis is associated with significant morbidity and mortality. The aim of this study was to assess the prevalence and the associated factors of factitious hypoglycaemia in non-diabetic patients.

Methods: This was a single-centre, retrospective study including 70 non-diabetic patients who were admitted for the investigation of hypoglycaemia. All patients fulfilled the Whipple triad. Epidemiological parameters, medical history, clinical and paraclinical data and the aetiology of hypoglycaemia were collected from medical records.

Results: The diagnosis of factitious hypoglycaemia was held in 11 patients (9 women and 2 men) corresponding to a prevalence of 16%. It was secondary to intentional insulin use in six patients and the ingestion of glibenclamide in five patients. The median age of the patients was 28 years (interquartile range: 21-43). Two patients with factitious hypoglycaemia had a personal history of psychiatric disorders. The other causes of hypoglycaemia were adrenal insufficiency (34%), prediabetes (24%), insulinoma (6%), iatrogenic hypoglycaemia (10%), criminal hypoglycaemia (1%) and alcohol intoxication (2%). Age ≤ 35 years (Odds Ratio = 5.6, p = .017), family history of diabetes mellitus (Odds Ratio = 1.29, p = .015), attention disorders during hypoglycaemia (Odds Ratio = 12.5, p = .017) and fasting glucose level <0.7 g/L (Odds Ratio = 5.75, p = .017) were positively associated with factitious hypoglycaemia.

Conclusion: Factors significantly associated with factitious hypoglycaemia were young age, family history of diabetes and a low fasting glucose level.

Keywords: factitious hypoglycaemia; hypoglycaemia in non-diabetic patients; insulin; insulin secretagogues medications; psychiatric care.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Aetiologies of hypoglycaemia in the study population
See this image and copyright information in PMC

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