A patient may develop hypoglycemia by all of the following EXCEPT:

• A. Excessive exercise
• B. Taking too little insulin
• C. Vomiting a meal
• D. Reduced caloric intake

Answer: (D)

Hypoglycemia happens when the amount of glucose in the blood falls because glucose input is low or insulin action is high relative to glucose. Excessive exercise increases how much glucose muscles use, which can lower blood sugar if you don’t replace it with carbohydrates or adjust insulin. Vomiting a meal reduces the carbohydrate entering the bloodstream, lowering glucose availability. Reduced caloric intake also lowers the overall glucose supply, which can precipitate low blood sugar in someone using insulin. Taking too little insulin, on the other hand, reduces insulin’s effect and tends to raise blood glucose rather than lower it. So the factor that would not cause hypoglycemia is taking too little insulin.