Hypoglycemia factitia: Munchhausen syndrome in diabetes mellitus.
The medical history of a 43-year-old non-insulin-dependent diabetic patient with severe and repetitive hypoglycemic episodes is reported. The exact diagnosis proved to be difficult. Finally, surreptitious insulin administration was documented by high serum insulin and low C-peptide values with an elevated molar ratio of insulin to C-peptide in peripheral venous blood during hypoglycemia. Confronting the patient with evidences of surreptitious insulin administration, hypoglycemic episodes abruptly stopped. Hypoglycemia factitia was assessed as a manifestation of Munchhausen syndrome in diabetes mellitus.
Jermendy
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Third Medical Department, Bajcsy-Zsilinszky Teaching Hospital, Budapest, Hungary.
D000328:Adult; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002096:C-Peptide / Q000097:blood / Q000187:drug effects / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007328:Insulin / Q000008:administration & dosage / Q000097:blood / Q000378:metabolism; D009110:Munchausen Syndrome
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin