Thursday, March 15, 2012

C-peptide , a clue for the " Doctor / Detective ".

Self inflicted and parent inflicted severe hypoglycemia in someone without diabetes is a challenge to diagnose and even more difficult to manage.
For reasons that have never been clear to me , one parent usually the mother , will induce severe hypoglycemia in one of their children.
 Hospitalization is required with close continuous observations of the patient and parents. C-peptide levels and other test such as islet cell antibodies, anti- Gad antibodies and insulin antibodies  are measured as a baseline and the C-peptide is repeated during any episode of hypoglycemia. Usually the hypoglycemia stops under close observation and reoccurs when the child is left alone with the offending person.

 Remember , C-peptide is a waste product of insulin production in our body. 
If someone is producing enough insulin to cause hypoglycemia then their should also be C-peptide present and measurable in their blood.

Commercially produced insulin does not contain C- peptide. Injected insulin has no C- peptide.

The official name for this problem is Munchausen syndrone by Proxy

Have fun , be Smart and Defeat Diabetes
David Calder,MD

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Your comments and questions are appreciated. David Calder,MD