Hypoglycemia and the Postprandial Syndrome

Although low blood glucose concentrations were known to occur in patients with various diseases in the 19th century, a clinical syndrome of hypoglycemia was not recognized until the early 1920s, when symptoms similar to those of insulin-induced hypoglycemia were observed in persons without diabetes. A new disease called hyperinsulinism and characterized by "hunger, weakness and the anxiety neuroses," was postulated.1 The subsequent identification of a pancreatic islet-cell tumor in a patient who had such symptoms concomitantly with low blood glucose concentrations confirmed the existence of hyperinsulinism.2 Whipple3 recommended that the sine qua non for the diagnosis of hyperinsulinism be the . . .