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HYPOGLYCEMIA
Check Insulin, glucose and C-peptide
If hypoglycemia secondary to Insulin: low C-Peptide
If hypoglycemia from the use of insulin secretagogues, such as sulfonylureas or meglitinides: elevated C-peptide levels.
If elevated Cpeptide do measurement of serum sulfonylurea levels to distinguish from INSULINOMA
If Insulinoma do CT abdomen
Check Insulin, glucose and C-peptide
If hypoglycemia secondary to Insulin: low C-Peptide
If hypoglycemia from the use of insulin secretagogues, such as sulfonylureas or meglitinides: elevated C-peptide levels.
If elevated Cpeptide do measurement of serum sulfonylurea levels to distinguish from INSULINOMA
If Insulinoma do CT abdomen
Schmidt’s syndrome or Autoimmune polyendocrine syndrome type 2.
- Characterized by
- Hypothyroidism
- Adrenal insufficiency (hyperkalemia, Hypoglycemia, metabolic acidosis, hyperpigmentation)
- Type I diabetes mellitus.
Treat adrenal insufficiency, is a potentially life-threatening condition , before starting thyroid replacement therapy start dexamethasone. After starting dexamethasone, start the patient on oral levothyroxine. After starting medications, perform a cosyntropin stimulation test to confirm that the patient has adrenal insufficiency. If the test is positive indicates that the patient does have adrenal insufficiency, then it would be appropriate to start hydrocortisone.
- Characterized by
- Hypothyroidism
- Adrenal insufficiency (hyperkalemia, Hypoglycemia, metabolic acidosis, hyperpigmentation)
- Type I diabetes mellitus.
Treat adrenal insufficiency, is a potentially life-threatening condition , before starting thyroid replacement therapy start dexamethasone. After starting dexamethasone, start the patient on oral levothyroxine. After starting medications, perform a cosyntropin stimulation test to confirm that the patient has adrenal insufficiency. If the test is positive indicates that the patient does have adrenal insufficiency, then it would be appropriate to start hydrocortisone.
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