Endocrine Abstracts

Diagnosis of hypoglycaemia presents few difficulties nowadays providing it is (a) thought of and (b) appropriate samples of blood are collected whilst the patient is hypoglycaemic for subsequent analysis in a suitable laboratory. Adherence by the laboratory to well defined protocol that will be presented and commences with confirmation that the glucose concentration in the plasma/serum specimen submitted for analysis is truly subnormal, will usually resolve the diagnostic dilemma. Difficulties may arise clinically when samples have not been collected appropriately or have been mishandled prior to receipt by the analyst and, forensically, when exogenous insulin or, more rarely, sulphonylureas have purportedly been used in furtherance of a crime, including 'Munchausen by Proxy' and murder, when more rigorous standards apply. Some of the problems encountered under these conditions will be discussed