Table 1

Common causes of adult spontaneous hypoglycaemia

Pancreatic
Insulinoma
Non-insulinoma pancreatogenic hypoglycaemia (NIPH)
Nesiodioblastosis
Pluriglandular syndrome
Multiple endocrine neoplasia type 1
Non-islet cell tumour hypoglycaemia
Insulin-like frowth factor II secreting tumours (for example, mesenchymal tumours, haemangiopericytomas, carcinomas of the liver, stomach, and adrenals)
Lymphoma, myeloma, and leukaemias
Metastatic cancer
Autoimmune hypoglycaemia
Autoimmune insulin syndrome (AIS)
Anti-insulin receptor
Pancreatic Graves disease
Reactive (alimentary) hypoglycaemia
Post-gastric surgery
Alcohol provoked reactive hypoglycaemia
Idiopathic
AIS
NIPH
Drug induced
Insulin
Sulfonylurea
Repaglinide
Salicylates
Paracetamol
Quinine
Haloperidol
Disopyramide
β Blockers
Pentamadine
Many others
Dietary toxins
Alcohol
Unripe ackee nuts
Mushrooms causing acute liver failure
Organ failure
Severe liver disease
Endstage renal disease and renal dialysis
Congestive cardiac failure
Acute respiratory failure
Endocrine disease
Generalised or selective hypopituitarism and hypothalamic insufficiency
Adrenal failure and cortisol resistance
Hypothyroidism
Postoperative removal of phaeochromocytoma
Inborn errors of metabolism
Glycogen storage disease
Hereditary fructose intolerance
Galactosaemia
Carnitine deficiency
Disorders of gluconeogenesis
Disorders of mitochondrial β oxidation
Miscellaneous
Sepsis
Starvation including anorexia nervosa
Total parenteral nutrition
Severe excessive exercise