I am a non diabetic patient and had few episodes
IT CAN BE INSULINOMA
DEAR SIR, ALL YOUR REPORTS THAT YOU HAVE SEND ARE NORMAL.
YOU NEED TO UNDERGO "PROLONGED SUPERVISED FASTING"
THAT CAN BE DONE ON ADMISSION ONLY. SO IF YOU CAN COME DOWN TO XXXXXXX YOU CAN SEE ME OR YOU CAN SEE ANY ENDO AT YOUR PLACE. IT IS A 72 HOURS ADMISSION. AND YOU MAY EVEN DO MIG SCAN PANCREAS TO FIND OUT THE PANCREATIC MASS.
symptoms are the most important marker.
dear sir, first thing , if you have no symptom , why did you check your sugars?
so definitely, most important thing is symptom. even when fasting, like during ramadan, paryushan, sawaan, karva chauth, people don't land with hypoglycemia and don't repeatedly check sugars. so if no symptom , please forget everything. but if you are symptomatic, and then check sugars and they come low, you need a work up.
CT abdomen with contrast for pancreas or mri with contrast for pancreas, or MIG for pancreas are the investigations of choice.
prolonged supervised fasting for 72 hrs is also diagnostic method.
blood glucometer errors, or capillary constriction due to cold temperature and small size of blood drop giving false low values are insignificant if you are symptomatic. if you are not symptomatic , please don't check sugars.
continue anti anxiety treatment in that case.
Dear sir, continue anti anxiety treatment in such a case. and if at all sugar falls again, keep in mind that the plan is
1. prolonged supervised fasting for 72 hrs.
2. MIG scan pancreas.
but as per the report there is no hypo! only symptoms?
dear sir, as you said sugars were above 70 post meal, so there is no hypoglycemia actually!
so reactive hypo is not a real pssibility, but keep monitoring post meal , 4 hrs.
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