We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Glucose-Resistant Hypoglycemia in Inanition

Alan N. Elias, MD; Grant Gwinup, MD
Arch Intern Med. 1982;142(4):743-746. doi:10.1001/archinte.1982.00340170099018.
Text Size: A A A
Published online


• Three patients had starvation-related hypoglycemia that was not responsive to the infusion of glucose. The patients resembled fatal cases of hypoglycemia seen very rarely in victims of kwashiorkor. None of the patients had a history of drug ingestion, nor was there any evidence of endocrine insufficiency. Two of the patients had low serum insulin levels. Complete postmortem examinations were done for all three patients and there was no evidence of islet cell abnormalities or of malignant neoplasms. A syndrome of severe hypoglycemia refractory to therapy, that was occasionally seen, in years past, in starved individuals is confirmed. The mechanisms underlying the disorder are obscure, but a failure of glycogenolysis, neoglucogenesis, or overproduction of insulin appear unlikely possibilities. It is postulated that cells normally impermeable to glucose, when serum insulin levels are low, become permeable in some severely starved patients, for reasons unknown.

(Arch Intern Med 1982;142:743-746)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.