Scientific Research and Essays Vol. 5(12), pp. 1479-1482, 18 June, 2010 Available online at http://www.academicjournals.org/SRE ISSN 1992-2248 ©2010 Academic Journals Full Length Research Paper Etiologies of patients admitted to emergency department with hypoglycemia Sevki Hakan Eren 1 *, Hacı Mehmet Caliskan 1 , Fatih Kilicli 2 , lhan Korkmaz 1 , Fettah Acibucu 3 and Hatice Sebila Dokmetas 2 1 Department of Emergency, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey. 2 Department of Endocrinology and Metabolism, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey. 3 Department of Internal Medicine, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey. Accepted 26 April, 2010 Hypoglycemia is the most common endocrinologic problem seen in emergency departments. To explore its causes in patients who admitted to the emergency department with symptoms resembling hypoglycemia, 225 hypoglycemia cases were evaluated from January 2000 to May 2008. Of 225 hypoglycemia cases, 158 (70.2%) were receiving treatment for diabetes mellitus, which was the most common group (94 patients were using insulin, 55 were receiving oral anti-diabetics (OAD) and 9 patients both OAD and insulin). The other causes for hypoglycemia were as follows: reactive hypoglycemia cases (11.6%), insulinoma (2.7%), malignancies (2.2%), Sheehan syndrome (0.9%), chronic liver disease (0.9%), gestational diabetes mellitus (0.4%), OAD use by mistake (3.6%), and use of OAD for suicidal purposes (13%). In eight of the cases, the reason could not be identified. The study revealed that diabetes mellitus constitute the most common reason for hypoglycemia among the patients seen in emergency departments. Efforts should be made to prevent hypoglycemia by giving the patients better education. Key words: Emergency department, hypoglycemia, endocrine emergency. INTRODUCTION Hypoglycemia is one of the most commonly seen endocrinologic problem in emergency departments and is defined as blood glucose level less than 50 mg/dL with hypoglycemic symptoms or blood glucose level less than 40 mg/dL (Boaz et al., 2001). Although the most common causes are diabetes mellitus (DM) and antidiabetic drugs, patients may be referred to emergency departments for rare reasons such as insulinoma, cancers, chronic liver failure, and endocrinologic disorders (Güven et al., 2000). Checking blood glucose level in patients having blackout as a result of consciousness, convulsion, confusion or abnormal behaviors should be one of the priorities for physicians in the emergency department and it should be kept in mind *Corresponding author. E-mail: shakaneren@hotmail.com. Tel: 0090346 2581744. that there may be other reasons for hypoglycemia other than DM. We have examined the underlying causes and incidence rates of patients admitted to hospital for hypoglycemia. PATIENTS AND METHODS In our study, we evaluated the patients referred to our emergency department of Cumhuriyet University Hospital. The patients who were hospitalized for other reasons and developed hypoglycemia during their hospitalization time were not included in the study. Cases above 15 years old were included in our study. Hypoglycemia was defined as blood glucose beneath 50 mg/dL (2.8 mmol/L) with neuroglicopenic symptoms or less than 40 mg/dL (2.2 mmol/L) without the necessity of neuroglicopenic symptoms. DM was defined as fasting plasma glucose (FPG) 126 mg/dL or as postprandial plasma glucose 200 mg/dL. Reactive hypoglycemia was diagnosed through extended glucose tolerance test. In order to determine endocrine-based hypoglycemic disease, basal and dynamic tests were applied. Malignancies were diagnosed through