Hypoglycemia: fact or fiction?

Many misconceptions continue to persist in both the lay and the professional literature regarding the proper approach to the diagnosis and treatment of hypoglycemia. Often, patients with a symptom complex suggestive of hypoglycemia have normal levels of plasma glucose in association with these symptoms. The major diagnostic error is the failure to document hypoglycemia (that is, record plasma glucose levels) at the time the patient is spontaneously symptomatic. This review details the requirements necessary for glucose homeostasis, defines organic hypoglycemia, and demonstrates a logical approach to the diagnosis and treatment of patients with this symptom complex.