In people without diabetes , hypoglycaemia is relatively uncommon but can occur due to: Prolonged fasting or inadequate carbohydrate intake Excessive alcohol consumption , particularly without food Certain medications , including specific antibiotics (e.g., fluoroquinolones), quinine, and pentamidine (though these are rare causes) Hormonal deficiencies affecting cortisol or growth hormone Rare conditions such as insulinomas (insulin-producing tumours) or reactive hypoglycaemia Critical illness or organ failure affecting the liver or kidneys For individuals with diabetes , hypoglycaemia is more frequent and typically results from: Insulin or sulphonylurea medications (such as gliclazide or glimepiride) Missed or delayed meals after taking glucose-lowering medication Increased physical activity without adjusting medication or food intake Alcohol consumption which impairs the liver's glucose production Medication errors or dose miscalculations Symptoms of hypoglycaemia include trembling, sweating, anxiety, hunger, palpitations, confusion, and in severe cases, loss of consciousness or seizures
Kaveh Gaynor-Sodeifi has no conflicts of interest to declare
TSH is the most sensitive marker, and high TSH and low free T4 confirm primary hypothyroidism
10.1016/j.bbrc.2018.05.120 59 LiF.ChenM.JiJ.TangR.HuangJ.ZhangX.et al (2022)
