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Reminder of important clinical lesson
CASE REPORT
Nocturnal reactive hypoglycaemia well treated subjectively and objectively with voglibose
  1. Hiroyuki Koyama,
  2. Hideomi Ohguchi,
  3. Takashi Yagi,
  4. Kenro Imaeda
  1. Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
  1. Correspondence to Dr Hiroyuki Koyama, hk0515{at}kuhp.kyoto-u.ac.jp

Summary

Clinicians sometimes encounter difficulty in diagnosing hypoglycaemia. Here, we present a case report of a 53-year-old woman with recurrent nocturnal hypoglycaemia. A continuous glucose monitoring system (CGMS) revealed postprandial hyperglycaemia and subsequent hypoglycaemia, and an oral glucose tolerance test showed an impaired glycaemic and delayed hyperinsulinaemic pattern. On the basis of these clinical findings, we diagnosed her unexplained hypoglycaemia as reactive hypoglycaemia. CGMS showed a sharp contrast of diurnal variation in blood glucose levels including hypoglycaemia between before and after treatment with an alpha-glucosidase inhibitor, voglibose. Her hypoglycaemic attacks disappeared.

  • diabetes
  • primary care

https://doi.org/10.1136/bcr-2017-220295

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    Footnotes

    • Contributors HK has charge of the patient’s history taking, attachment and detachment of CGMS and drafting the article. HO and TY have charge of the arrangement of the examinations including MRI/OGTT/CGMS and collecting and interpreting the data (OGTT, CGMS). KI is the head of our department. We gather everyone together and argue about the patient to achieve a correct diagnosis. He also had final approval of the article to be published.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.