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Tests and diagnosis

By Mayo Clinic staff

Your doctor will use three criteria — often referred to as Whipple's triad — to diagnose hypoglycemia. Whipple's triad includes the following factors:

  • Signs and symptoms of hypoglycemia. You may not exhibit signs and symptoms of hypoglycemia during your initial visit with your doctor. In this case, your doctor may have you fast overnight. This will allow hypoglycemic symptoms to occur so that he or she can make a diagnosis. It's also possible that you'll need to undergo an extended fast in a hospital setting. Or if your symptoms occur after a meal, your doctor will want to test your glucose levels after a meal.
  • Documentation of low blood glucose when the signs and symptoms occur. Your doctor will draw a sample of your blood to be analyzed in the laboratory.
  • Disappearance of the signs and symptoms. The third part of the diagnostic triad involves whether your signs and symptoms go away when blood glucose levels are raised.

In addition, your doctor will likely conduct a physical examination and review your medical history.

References
  1. Patient guide on the diagnosis and management of hypoglycemic disorders (low blood sugar) in adults. The Hormone Foundation. http://www.hormone.org/Resources/upload/patient-guide-diagnosis-and-management-hypoglycemia-022509.pdf. Accessed Nov. 12, 2011.
  2. Aminoff MJ, et al. Disorders of cognitive function. Clinical Neurology. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=5143601.
    Accessed Nov. 16, 2011.
  3. Hypoglycemia. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/index.htm. Accessed Nov. 13, 2011.
  4. Hypoglycemia (low blood glucose). American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html. Accessed Nov. 13, 2011.
  5. Cryer PE, et al. Hypoglycemia. In: Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9141631. Accessed Nov. 16, 2011.
  6. Josefson J, et al. Hypoglycemia in the emergency department. Clinical Pediatric Emergency Medicine. 2009;10:285.
  7. Cryer PE. Hypoglycemia in type 1 diabetes mellitus. Endocrinology and Metabolism Clinics of North America. 2010;39:641.
  8. Masharani U, et al. Pancreatic hormones and diabetes mellitus. In: Gardner DG, et al. Greenspan's Basic & Clinical Endocrinology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=8407307. Accessed Nov. 16, 2011.
  9. Goyal N, et al. Type 1 diabetes mellitus. In: Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=6379758. Accessed Nov. 16, 2011.
  10. Vella A, et al. Hypoglycemia and pancreatic islet cell disorders. In: Goldman L, et al. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-1604-7..00238-4&isbn=978-1-4377-1604-7&uniqId=303466088-3#4-u1.0-B978-1-4377-1604-7..00238-4--s0010. Accessed Nov. 21, 2011.
  11. Service FJ (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 18, 2011.
DS00198 Feb. 22, 2012

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