Factitious hypoglycemia. Diagnosis by measurement of serum C-peptide immunoreactivity and insulin-binding antibodies.
In seven patients with factitious hypoglycemia due to the surreptitious injection of insulin, we made the diagnosis by measurements of plasma insulin and C-peptide immunoreactivity (in seven patients), facilitated by the finding of circulating insulin-binding antibodies (in two patients). The simultaneous demonstration of low plasma glucose, high immunoreactive insulin and suppressed C-peptide immunoreactivity represents a triad of results pathognomonic of exogenous insulin administration. Determination of plasma free C-peptide and free insulin permitted patients with high titers of insulin antibodies, including those with a history of insulin-treated diabetes, to be studied and diagnosed in a way similar to that in subjects who had no circulating insulin antibodies.
D007516:Adenoma, Islet Cell / Q000150:complications; D000293:Adolescent; D000328:Adult; D002096:C-Peptide / Q000097:blood / Q000276:immunology*; D002675:Child, Preschool; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis* / Q000209:etiology; D007328:Insulin / Q000009:adverse effects; D007330:Insulin Antibodies / Q000032:analysis*; D008297:Male; D010190:Pancreatic Neoplasms / Q000150:complications; D010455:Peptides / Q000276:immunology*; D012651:Self Medication / Q000009:adverse effects; D019966:Substance-Related Disorders
D002096:C-Peptide; D007328:Insulin; D007330:Insulin Antibodies; D010455:Peptides