Approach to Hypoglycaemia at the Emergency Department: Diagnosis, Treatment, and Follow-up

Abstract

Hypoglycemia is an important metabolic emergency that must be recognized rapidly and treated without delay in the emergency department, with a clinical spectrum ranging from mild autonomic symptoms to seizures, coma, and permanent neurologic injury. In adults without diabetes, Whipple's triad remains a practical guide in diagnostic evaluation; it consists of symptoms compatible with hypoglycemia, documentation of low plasma glucose, and resolution of symptoms after correction of the glucose level. Treatment-related hypoglycemia is among the most common causes, particularly in patients using insulin or sulfonylureas; however, sepsis, hepatic and renal failure, adrenal insufficiency, alcohol use, prolonged fasting, and critical illness should also be considered in the etiologic assessment. In recent years, postprandial hypoglycemia after bariatric surgery has also emerged as a distinctive clinical entity that should be considered in emergency presentations. The cornerstone of emergency management is early recognition, simultaneous glucose measurement, prompt initiation of appropriate treatment, and follow-up planning according to the risk of recurrence.

Keywords: Hypoglycemia; Emergency Department; Whipple's Triad; Bariatric Surgery; Follow Up

Citation

Kilic M, Buyukbese MA. Approach to Hypoglycaemia at the Emergency Department: Diagnosis, Treatment, and Follow-up. WebLog J Emerg Med. wjem.2026.f1102. https://doi.org/10.5281/zenodo.20949693