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March 11, 1961

Factitious Hypoglycemia Due to ChlorpropamideReport of a Case, with Clinical Similarity to an Islet Cell Tumor of the Pancreas

Author Affiliations

Philadelphia

From the Division of Medicine, Pennsylvania Hospital.; Professor of Medicine, University of Pennsylvania, and Director of the Medical Divisions of the Pennsylvania Hospital and the Benjamin Franklin Clinic (Dr. Duncan), Instructor in Medicine, University of Pennsylvania, and Assistant Physician at the Pennsylvania Hospital (Dr. Jenson); and Assistant Instructor in Medicine, University of Pennsylvania, Resident Physician in Medicine, Pennsylvania Hospital, and Teaching Fellow National Thoracic Society 1959-1960 (Dr. Eberly).

JAMA. 1961;175(10):904-906. doi:10.1001/jama.1961.63040100019020
Abstract

FACTITIOUS HYPOGLYCEMIA, or hypoglycemia due to surreptitious self-administration of insulin, is an uncommon but recognized entity.1,2 Conn and Seltzer3 reported 1 case and Rynearson4 reported 3 such cases, in one of which 7 exploratory operations and an eventual total pancreatectomy were performed in attempts to remove a suspected functioning islet cell tumor of the pancreas. It has been suggested that factitious hypoglycemia be suspected in patients who are diabetic, in the family of the diabetic, or in medical personnel such as physicians or nurses to whom knowledge of hypoglycemic agents and their actions is readily accessible.

Oral hypoglycemic agents employed in the treatment of diabetes vary in their hypoglycemia-producing properties. Tolbutamide (Orinase) rarely provokes hypoglycemia, whereas unless guarded against, chlorpropamide (Diabinese) is not an infrequent cause of abnormally low concentrations of sugar in the blood.

No reported case of factitious use of chlorpropamide in producing clinical

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