c-peptide and Substance-Related-Disorders

Topics: Adrenocorticotropic Hormone; Analgesia; Animals; Avoidance Learning; beta-Lipotropin; C-Peptide; Drug Tolerance; Humans; Hypothalamo-Hypophyseal System; Learning; Melanocyte-Stimulating Hormones; Memory; Motivation; Nerve Tissue Proteins; Peptides; Pituitary Hormones; Sleep; Structure-Activity Relationship; Substance-Related Disorders; Vasopressins

Factitious hypoglycemia is similar in presentation to insulinoma and occurs most commonly in persons with ready access to insulin. Diagnosis previously was based on circumstantial evidence but now can be confirmed by demonstration of high insulin levels and low C-peptide levels in the presence of hypoglycemia. Treatment is primarily psychiatric, and success so far is limited.

Topics: Adult; Blood Glucose; C-Peptide; Factitious Disorders; Female; Humans; Hypoglycemia; Insulin; Middle Aged; Self Administration; Substance-Related Disorders

In seven patients with factitious hypoglycemia due to the surreptitious injection of insulin, we made the diagnosis by measurements of plasma insulin and C-peptide immunoreactivity (in seven patients), facilitated by the finding of circulating insulin-binding antibodies (in two patients). The simultaneous demonstration of low plasma glucose, high immunoreactive insulin and suppressed C-peptide immunoreactivity represents a triad of results pathognomonic of exogenous insulin administration. Determination of plasma free C-peptide and free insulin permitted patients with high titers of insulin antibodies, including those with a history of insulin-treated diabetes, to be studied and diagnosed in a way similar to that in subjects who had no circulating insulin antibodies.

Topics: Adenoma, Islet Cell; Adolescent; Adult; C-Peptide; Child, Preschool; Diabetes Complications; Female; Humans; Hypoglycemia; Insulin; Insulin Antibodies; Male; Pancreatic Neoplasms; Peptides; Self Medication; Substance-Related Disorders