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Psychiatria Danubina, Vol. 32 No. suppl. 1, 2020.

Conference paper

FACTITIOUS HYPOGLYCAEMIA: A CASE REPORT AND LITERATURE REVIEW

Harry Kyriacou ; School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom
William Duggleby ; School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom
Adam Hatoum ; School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom
Tahir Khan ; School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom
George Manley ; School of Clinical Medicine, Addenbrookes Hospital, University of Cambridge, Cambridge, United Kingdom
Maria Filippidou ; Department of Liaison Psychiatry, Bedford Hospital, Bedfordshire, United Kingdom

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Abstract

Background: Factitious hypoglycaemia is a form of factitious disorder imposed on self with high morbidity and mortality. It is
therefore important to be aware of the key demographic and contextual risk factors for factitious hypoglycaemia, as well the
investigations and management options available for suspected cases.
Subjects and methods: In this article we describe a case report and literature review of factitious hypoglycaemia. The search
was conducted using the PubMed database and identified 23 case reports of 31 patients aged 18 or over with insulin-induced
factitious hypoglycaemia.
Results: The average age of these patients was 33.7 (±13.5) years, the female: male ratio was 4.3:1, 38% had medical occupations
or past medical training, 53% had diabetes mellitus, and 41% had a positive psychiatric history. Misdiagnoses were common
and often resulted in inappropriate treatment. Very few cases discussed psychiatric management.
Conclusions: Factitious hypoglycaemia is more commonly reported in middle-aged females, in a medical profession, with a past
medical history of diabetes mellitus and psychiatric illness. However, it may affect a variety of patients and the absence of these
features should not discourage a diagnosis. C-peptide levels and insulin assays can help identify factitious hypoglycaemia over other causes of hypoglycaemia, and management should include a greater focus on psychiatric treatment.

Keywords

factitious disorder; hypoglycaemia; Munchausens syndrome

Hrčak ID:

262501

URI

https://hrcak.srce.hr/262501

Publication date:

24.3.2020.

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