Samaan N A
University of Texas M. D. Anderson Hospital and Tumor Institute, Houston.
Endocrinol Metab Clin North Am. 1989 Mar;18(1):145-54.
Hypoglycemia secondary to endocrine deficiencies is uncommon, but it occurs. The endocrine deficiency may be of hypothalamic-pituitary origin or may be due to primary failure of the adrenal gland or the thyroid gland. If hypoglycemia is suspected, the diagnosis should be established immediately by measurement of the blood sugar level. Blood should also be obtained for subsequent use in confirming the diagnosis of the endocrine disease responsible for causing the hypoglycemia. A 50% dextrose in water solution should immediately be injected, and fluid therapy consisting of 5% dextrose in normal saline should be initiated. Intravenous cortisone should be given if primary or secondary adrenal cortical insufficiency is suspected until the results of the biochemical tests become available. If hypothyroidism is suspected, intravenous L-thyroxine should be given carefully in addition to the cortisone treatment. Failure in recognizing hormone deficiencies as the cause of hypoglycemia in some patients and failure in promptly correcting the condition may lead to fatal consequences.
继发于内分泌缺乏的低血糖并不常见，但确实会发生。内分泌缺乏可能源于下丘脑 - 垂体，也可能是由于肾上腺或甲状腺的原发性功能衰竭。如果怀疑有低血糖，应立即通过测量血糖水平来确诊。还应采集血液以供后续用于确认导致低血糖的内分泌疾病的诊断。应立即注射50%的葡萄糖水溶液，并开始用生理盐水加5%葡萄糖的液体疗法。如果怀疑有原发性或继发性肾上腺皮质功能不全，应给予静脉注射可的松，直至生化检查结果出来。如果怀疑有甲状腺功能减退，除了可的松治疗外，应谨慎给予静脉注射L - 甲状腺素。在一些患者中未能认识到激素缺乏是低血糖的原因，以及未能及时纠正这种情况可能会导致致命后果。
