Hepatic, Renal, and Endocrine Disease
Hypoglycemia secondary to liver disease, other than that due to hepatomas, is rare and is usually associated with massive hepatic necrosis. In order for hypoglycemia to occur as a result of liver disease, approximately 80 to 90 per cent of the liver must be destroyed, and therefore the hypoglycemia is frequently a premorbid event. Hypoglycemia that occurs in the setting of cirrhosis is most commonly due to ethanol ingestion.
In patients with Addison’s disease hypoglycemia will occur with prolonged fasting. Adequate Cortisol replacement prevents the hypoglycemia. Hypopituitarism, regardless of etiology, may also result in hypoglycemia because of low Cortisol levels and impaired growth hormone production. Cortisol replacement prevents symptomatic hypoglycemia in adults, but in children hypoglycemia can still occur despite adequate Cortisol replacement.
Occasional patients with chronic renal failure develop hypoglycemia; this complication is observed most commonly in cachectic individuals.
Tags: addison, adults, chronic renal failure, endocrine disease, ethanol, growth hormone, hepatic necrosis, hormone production, hypoglycemia, ingestion, liver disease, low cortisol levels