All of the following conditions, are associated with the development of hypoglycemia except:
Acromegaly is associated with the development of hyperglycemia. Diabetes mellitus develops in 25% of patients with acromegaly, and most patients are intolerant of a glucose load. It occur due to the excess of growth hormone that induces resistance against insulin activity. At supraphysiologic doses, growth hormone antagonizes the actions of insulin, resulting in an increase in hepatic glucose production and reduction in carbohydrate oxidation and hepatic and peripheral insulin sensitivity. Causes of hypoglycemia: 1. Drugs: ? Insulin or Insulin secretagogue ? Alcohol 2. Critical illness: ? Hepatic (Hepatocellular failure), renal (uremia) or cardiac failure ? Sepsis ? Inanition 3. Hormone deficiency: ? Coisol ? Glucagon and epinephrine (in insulin-deficient diabetes) 4. Non-islet cell tumor 5. Endogenous hyperinsulinism: ? Insulinoma ? Functional beta-cell disorders (nesidioblastosis) ? Noninsulinoma pancreatogenous hypoglycemia ? Post-gastric bypass hypoglycemia ? Insulin autoimmune hypoglycemia ? Antibody to insulin ? Antibody to insulin receptor ? Insulin secretagogue 6. Accidental, surreptitious or malicious hypoglycemia Ref: Harrison's Principle of Internal Medicine, 18th Edition, Page 3003, Chapter 339 ; Transnasal Endoscopic Skull Base and Brain Surgery: Tips and Pearls By Aldo Stamm, Page 4-34 ; Growth Hormone Related Diseases and Therapy By Ken Ho, Page 68
Uremia
Acromegaly
Addison's disease
Hepatocellular failure