The general availability of potent sulphonylurea preparations and the ease with which they can be taken, may explain the increase in both the iatrogenic and factitious hypoglycaemia caused by them (Refs 1,2). Whereas insulin‐induced hypoglycaemia is relatively easy to diagnose in the laboratory, that caused by a sulphonylurea may not be, mainly because its biochemical features in many respects resemble those observed in insulinoma. In both conditions plasma insulin and C‐peptide concentrations are inappropriately high during hypoglycaemia and B‐hydroxybutyrate levels are low. The only sure way to distinguish between them in the absence of a positive history of ingestion, is by detection of sulphonylurea in the patient's blood. We describe here a typical case presentation and a preliminary assessment of the incidence of sulphonylurea‐induced factitious hypoglycaemia from a survey of 151 cases of “spontaneous” hypoglycaemia.
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Teale et al. (1989) studied this question.