The following symptoms and complaints may indicate hyperinsulinemia:
Leading symptoms
- Chronic hypoglycemia (hypoglycemia; blood glucose concentration below the physiologic norm of 60 mg/dl or 3.3 mmol/l) [see below for classification of hypoglycemia by severity].
The signs of hypoglycemia depend on the degree of hypoglycemia. According to the severity of hypoglycemia, three groups are distinguished:
Autonomic signs (synonym: adrenergic signs). These result from a reactive release of adrenaline. These signs include:
- Paleness
- Ravenous hunger
- Palpitations (heart palpitations)
- Sweating
- Tachycardia (heartbeat too fast: > 100 beats per minute).
- Tremor (shaking)
Neuroglycopenic signs: These signs result from glucose deficiency in the central nervous system (CNS) (usually appearing only at blood glucose concentrations < 50 mg/dl). Glycopenia affects numerous neuronal functions and manifests as follows:
- Atypical behavior (aggressiveness; anxiety).
- Drowsiness
- Paresthesias (non-painful sensation in the area supplied by a cutaneous nerve with signs such as: Tingling, “formication”, furriness, tingling, itching, etc.).
- Speech disorders (aphasia)
- Visual disturbances such as blurred vision, diplopia (double vision, double images).
- Confusion
- Transient hemiplegia (temporary hemiplegia.
- Psychosis or delirium
If blood glucose levels continue to fall (< 30-40 mg/dl), severe neurological disorders develop:
- Epilepsy (seizures).
- Unconsciousness
- Coma
Nonspecific signs. These represent accompanying symptoms that are not characteristic of hypoglycemia:
- Cephalgia (headache).
- Nausea (nausea)
- Vertigo (dizziness)
Caution. In slow-onset hypoglycemia, autonomic signs may be absent and neuroglycopenic signs may appear without warning. This then suddenly leads to severe central nervous system dysfunction (hypoglycemic shock).
