Evaluation of hypoglycemic symptoms in adults without diabetes mellitus

* If laboratory glucose measurement is pursued, insulin, C-peptide, and proinsulin levels should be obtained concurrently at the time of hypoglycemic symptoms. A detailed approach to home blood glucose monitoring with fingersticks and a glucose meter is described in other UpToDate content. Continuous glucose monitoring should not be used in the evaluation of hypoglycemic symptoms in individuals without diabetes.

¶ The duration of continued monitoring depends on factors including frequency of hypoglycemic symptoms and clinical suspicion for an underlying hypoglycemic disorder.

Δ Supervised testing can entail a supervised fast or mixed meal test, or evaluation may be performed during a spontaneous episode of hypoglycemia. Selection of a supervised test when hypoglycemia is not fortuitously observed depends on the timing of symptoms in relation to meals. These options are reviewed in detail in other UpToDate content.