Endocrine Abstracts

Introduction: Hypoglycemia is a decrease of glucose in blood, which can lead to coma and death. One of the causes of hypoglycemia in patients without diabetes mellitus (DM) is deliberate intake of hypoglycemic drugs (factitious hypoglycaemia, FH, Munchausen syndrome).

Objectives: To present the psychosocial characteristics of patients with FH.

Methods: Anamnesis analysis of 431 patients with hypoglycemia aged 18-93 years.

Results: FH was diagnosed in 15 (3,5%) patients: due to taking antidiabetic pills (n=5) or insulin administration (n=10); age 34 (min-max: 18-47) years; n=13 females (87%); n=1 with DM and n=11 (73%) had relatives with DM; n=2 were medical workers and n=1 had medical worker as a relative. n=5 had a hypoglycemic coma in anamnesis, of them n=2 repeatedly. n=4 underwent unreasonable invasive intervention on the pancreas. FH was combined with factitious DM (n=4) and with factitious hypercorticism (n=1). Diagnosis, according to ICD-10: [F40] n=3, [F45] n=2, [F44.8] n=1, [F07.0] n=1 and [F48.0] n=1. n=7 (47%) refused psychiatric examination. 87% of patients were unemployed. The possible causes of FH were: free temporary accommodation and meals in the hospital, avoiding compulsory military service and work, speeding up kidney transplantation. After presenting evidence of FH, none of the patients confirmed this fact, but did not try to prove the opposite.

Conclusions: The main features of patients with FH are: young age, women, lack of work, relatives with DM. All patients, examined by a psychiatrist, had various mental disorders.