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Clinical Case 5
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Objectives:

  • Evaluate a patient with possible hypoglycemia
  • Treat a patient with postprandial hypoglycemia
  • Identify causes of hypoglycemia



1

A 32-year-old thin female presents to your office complaining of “hypoglycemia.” She notices that about 2–3 hours after a meal she gets nauseated, shaky, and irritable. When she wakes up in the morning she generally feels well, even though she eats dinner at about 5:00 p.m. and does not eat any snacks afterward and generally does not have breakfast until 8:00 a.m. You can tell her that:
A)She likely has an insulinoma.
B)She likely will have normal blood sugars when she feels shaky.
C)Hypoglycemia does not exist as an entity in this form and she likely has anxiety.
D)She likely has “fasting” hypoglycemia.
E)None of the above.
2

All of the following are associated with postprandial hypoglycemia EXCEPT:
A)Early diabetes.
B)Alcohol intake.
C)Postgastrectomy syndrome.
D)Beta-blockers.
E)Diuretics.
3

You advise this patient to do all of the following EXCEPT:
A)Increase the amount of simple carbohydrates with her meals.
B)Increase the amount of complex carbohydrates with her meals.
C)Eat smaller, more frequent meals.
D)Use propantheline to delay gastric emptying.
E)None of the above is correct.







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