The reference range for a fasting plasma glucose level is between 70 and 99 mg/dL. Hypoglycemia is best documented by a plasma venous glucose level less than 50 mg/ dL, although there is considerable variability in the level of hypoglycemia that causes symptoms. Asymptomatic hypo-glycemia in a patient not taking insulin or oral hypoglyce-mic agents may be a laboratory artifact caused by ongoing metabolism of glucose in the specimen, especially if a delay has occurred in processing the specimen. The diagnosis of hypoglycemia is best made with typical symptoms associated with a laboratory confirmation of venous hypoglyce-mia, followed by relief of symptoms after ingesting glucose. The glucose tolerance test (GTT) can produce hypoglycemia in normal persons and should not be routinely ordered in the evaluation of hypoglycemia.

Hypoglycemia can be defined as iatrogenic, postprandial, or fasting. Postprandial hypoglycemia occurs after meals and is usually mild and self-limiting. Alimentary hypoglycemia occurs when patients have rapid gastric emptying. Insulin levels rise rapidly after a meal and fall more slowly than glucose levels, which results in hypoglycemia. Fasting hypoglycemia is seen much less often than reactive hypoglycemia and may be a harbinger of more severe disease, including insulin-producing pancreatic tumors and hepatic, adrenal, or renal insufficiency, or it may be the result of excess insulin or sulfonylurea administration. True fasting hypoglycemia needs to be confirmed by a prolonged fast, with simultaneous measurement of glucose and insulin. This technique can help determine whether the hypoglycemia is associated with excess insulin.

Diabetes mellitus is characterized by hyperglycemia. The American Diabetes Association has defined normal fasting plasma glucose as less than 100 mg/dL (5.6 mmol/L), prediabetes as 100 to 125 mg/dL (5.6-6.9 mmol/L), and diabetes mellitus as 126 mg/dL (7.0 mmol/L) or greater.

Delicious Diabetic Recipes

Delicious Diabetic Recipes

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