Hypoglycemia (Low Blood Sugar): Medical History

Medical history (history of illness) represents an important component in the diagnosis of hypoglycemia (hypoglycemia).

Family history

Social history

  • What is your occupation?
  • Do you work hard physically?

Current medical history/systemic history (somatic and psychological complaints).

  • What symptoms have you noticed?
    • Paleness
    • Ravenous hunger
    • Palpitations
    • Sweating
    • Palpitations
    • Tremor
  • How long have these symptoms been present?
  • Have you been able to identify any other symptoms?
  • When did you last eat/drink? What did you eat/drink?
  • Has this symptomatology occurred more often? If yes, how long has the symptomatology been occurring? Was there a triggering moment?

Vegetative anamnesis incl. nutritional anamnesis.

  • Are you overweight? Please tell us your body weight (in kg) and height (in cm).
  • Do you eat a balanced diet?
  • Do you get enough exercise every day?
  • Do you drink alcohol? If so, what drink(s) and how many glasses per day?

Self history incl. medication history.

  • Pre-existing conditions (diabetes mellitus; diseases of the nervous system; cardiovascular disease).
  • Operations
  • Allergies
  • Environmental history / intoxications (poisonings) – fungal toxins; ackee fruit; alcohol excess, especially in the presence of severe concomitant diseases; alcohol in diabetes mellitus.

Medication history

  • Analgesics (painkillers)
  • Antiarrhythmics
    • Quinidine
    • Disopyramide
  • Antibiotics
  • Antidiabetic drugs
    • Glinides (nateglinide, repaglinide)
    • Insulin overdose (esp. higher hypoglycemic tendency in women).
    • Overdose of sulfonylureas (SH) – glibenclamide, gliclazide, glimepiride, glipizide, gliquidone, tolbutamide.
    • SH (glipizide or glimepiride) in combination with a vitamin K antagonist (VKA; in this case, warfarin):
      • 22% increased risk of hypoglycemia (odds ratio [OR] 1.22); aged 65-74 years (OR 1.54) and in quarters with first-time warfarin use (OR 2.47).
      • 47% increased risk of fall-related fractures (broken bones) that brought patients to the emergency department or led to hospitalization (OR 1.47)
      • 22% increased risk for cognitive impairment (reductions in mental performance) (OR 1.22)
  • Quinine (a naturally occurring chemical compound in cinchona bark from the group of alkaloids).
  • Haloperidol (neuroleptic from the group of butyrophenones).
  • Combination of several antidiabetic drugs
  • Pentamidine (active ingredient from the group of antiparasitics).
  • Salicylate

Literature