A three-step approach: Whipple’s Triad
A diagnosis of hypoglycemia is not based only on symptoms. Rather, endocrinologists look for the presence Whipple's Triad, named for Allen O.Whipple, MD. These three factors help doctors diagnose hypoglycemia, or low blood sugar (blood glucose).
Whipple's Triad involves:
- low blood glucose level
- symptoms of hypoglycemia at the time of the low glucose level
- symptom relief with treatment of hypoglycemia
According to the textbook Henry's Clinical Diagnosis and Management by Laboratory Methods, a blood glucose level equal to or below 50mg/dL (normal blood glucose is 80-120) without the presence of diabetes warrants proper medical assessment.
Fasting or reactive hypoglycemia is diagnosed by a blood test to measure blood glucose. The test may be performed after fasting overnight, physical activity, or between meals.
Of course, if your endocrinologist suspects a hormone deficiency, pancreatic tumor, or another cause of hypoglycemia, further testing and evaluation is required.
- Guettier JM, Gorden P. Hypoglycemia. Endocrinology and Metabolism Clinics of North America. 2006;35(4):753-766.
- Hypoglycemia page. Mayo Clinic Health Information Web site. Available at: http://www.mayoclinic.com/health/hypoglycemia/DS00198. Accessed May 5, 2009.
- Hypoglycemia page. National Diabetes Information Clearinghouse (NDIC) Web site. Available at: http://diabetes.niddk.nih.gov/dm/pubs/hypoglycemia/. Accessed May 5, 2009.
- Kronenberg HM, Melmed Shlomo, Polonsky KS, Larsen PR. Chapter 33, Glucose Homeostasis and Hypoglycemia. In: Williams Textbook of Endocrinology, 11th Ed. St. Louis, MO: W. B. Saunders Company (Elsevier);2008.
- McPherson RA, Pincus MR. Henry's Clinical Diagnosis and Management by Laboratory Methods, 21st Ed. St. Louis, MO: W.B. Saunders Company (Elsevier);2007.