Hypoglycaemia in non-diabetic patient

Availability

North South North West Statewide

Pre-referral work-up

History

All referrals should comply to referral standards and also include:

  • Pattern of symptoms – post prandial or fasting, relieved by carbohydrates
  • Previous abdominal surgery
  • Access to hypoglycaemic medications

Tests

  • Capillary, plasma glucose at time of symptoms
  • Paired plasma glucose and insulin
  • 2 hour GTT to exclude diabetes or IGT
  • LFTs, U&E
  • Plasma cortisol
  • 24-hour calcium

Interim/GP management

To refer a patient with this condition, please see the Endocrinology clinic page for the full referral process and templates.

Condition can be divided into reactive (post prandial) – with usual causes being young fit lean adult, IGT, early NIDDM or dumping syndrome, or fasting – causes insulin excess especially insulinoma, liver failure, hypoadrenalism, growth hormone deficiency, sulphonylureas, insulin.

Do not fast outpatient with suspected insulinoma.

For more information please see the Tasmanian Health Pathways website.

Urgent / category 1

All patients with fasting hypoglycaemia

Semi-urgent / category 2

Suspected hypoglycaemia

Routine / category 3

Reactive hypoglycaemia not responding to diet

Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency:

Proceed to Emergency Department (ED). Please contact ED Medical Officer in Charge:
LGH ED – Phone: (03) 6777 6405  Fax: (03) 6348 7382
MCH ED – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED – Phone: (03) 6493 6340  Fax: (03) 6464 1926
RHH ED - Phone: (03) 6166 6100  Fax: (03) 6173 0489

Urgent:

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment