Evidence map›Paper›PMID 40789619›Full record

ArticleJournal of the American Board of Family Medicine : JABFM2025

Evaluation of Asymptomatic Fasting Hypoglycemia in Outpatients Without Diabetes.

Tomás González-Vidal, Óscar Lado-Baleato, Carmen Fernández-Merino, Juan Sánchez-Castro, Manuela Alonso-Sampedro, Jessica Ares, Elías Delgado, Edelmiro Menéndez-Torre, Francisco Gude

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Article in Journal of the American Board of Family Medicine : JABFM, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. The 4Cs of Primary Care, Leveraging Artificial Intelligence, and Improving Clinical Practice.Journal of the American Board of Family Medicine : JABFM · 2025
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Tomás González-VidalFrom the Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain (TGV, JA, ED, EMT); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain (TGV, JA, ED, EMT); Department of Medicine, University of Oviedo, Spain (TGV, JA, ED, EMT); Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS, ÓLB, FG); Santiago de Compostela, Spain (OLB, CFM, JSC, MAS); ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain (OLB); A Estrada Primary Care Center, A Estrada, Spain (CFM, JSC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPSISCIII), Santiago de Compostela, Spain (CFM, JSC, MAS, FG); Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain (ED, EMT); Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (CFM, FG); and Concepción Arenal Primary Care Center, Santiago de Compostela, Spain (FG). uo302763@uniovi.es).
Óscar Lado-BaleatoFrom the Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain (TGV, JA, ED, EMT); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain (TGV, JA, ED, EMT); Department of Medicine, University of Oviedo, Spain (TGV, JA, ED, EMT); Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS, ÓLB, FG); Santiago de Compostela, Spain (OLB, CFM, JSC, MAS); ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain (OLB); A Estrada Primary Care Center, A Estrada, Spain (CFM, JSC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPSISCIII), Santiago de Compostela, Spain (CFM, JSC, MAS, FG); Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain (ED, EMT); Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (CFM, FG); and Concepción Arenal Primary Care Center, Santiago de Compostela, Spain (FG).
Carmen Fernández-MerinoFrom the Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain (TGV, JA, ED, EMT); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain (TGV, JA, ED, EMT); Department of Medicine, University of Oviedo, Spain (TGV, JA, ED, EMT); Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS, ÓLB, FG); Santiago de Compostela, Spain (OLB, CFM, JSC, MAS); ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain (OLB); A Estrada Primary Care Center, A Estrada, Spain (CFM, JSC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPSISCIII), Santiago de Compostela, Spain (CFM, JSC, MAS, FG); Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain (ED, EMT); Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (CFM, FG); and Concepción Arenal Primary Care Center, Santiago de Compostela, Spain (FG).
Juan Sánchez-CastroFrom the Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain (TGV, JA, ED, EMT); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain (TGV, JA, ED, EMT); Department of Medicine, University of Oviedo, Spain (TGV, JA, ED, EMT); Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS, ÓLB, FG); Santiago de Compostela, Spain (OLB, CFM, JSC, MAS); ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain (OLB); A Estrada Primary Care Center, A Estrada, Spain (CFM, JSC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPSISCIII), Santiago de Compostela, Spain (CFM, JSC, MAS, FG); Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain (ED, EMT); Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (CFM, FG); and Concepción Arenal Primary Care Center, Santiago de Compostela, Spain (FG).
Manuela Alonso-SampedroFrom the Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain (TGV, JA, ED, EMT); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain (TGV, JA, ED, EMT); Department of Medicine, University of Oviedo, Spain (TGV, JA, ED, EMT); Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS, ÓLB, FG); Santiago de Compostela, Spain (OLB, CFM, JSC, MAS); ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain (OLB); A Estrada Primary Care Center, A Estrada, Spain (CFM, JSC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPSISCIII), Santiago de Compostela, Spain (CFM, JSC, MAS, FG); Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain (ED, EMT); Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (CFM, FG); and Concepción Arenal Primary Care Center, Santiago de Compostela, Spain (FG).
Jessica AresFrom the Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain (TGV, JA, ED, EMT); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain (TGV, JA, ED, EMT); Department of Medicine, University of Oviedo, Spain (TGV, JA, ED, EMT); Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS, ÓLB, FG); Santiago de Compostela, Spain (OLB, CFM, JSC, MAS); ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain (OLB); A Estrada Primary Care Center, A Estrada, Spain (CFM, JSC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPSISCIII), Santiago de Compostela, Spain (CFM, JSC, MAS, FG); Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain (ED, EMT); Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (CFM, FG); and Concepción Arenal Primary Care Center, Santiago de Compostela, Spain (FG).
Elías DelgadoFrom the Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain (TGV, JA, ED, EMT); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain (TGV, JA, ED, EMT); Department of Medicine, University of Oviedo, Spain (TGV, JA, ED, EMT); Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS, ÓLB, FG); Santiago de Compostela, Spain (OLB, CFM, JSC, MAS); ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain (OLB); A Estrada Primary Care Center, A Estrada, Spain (CFM, JSC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPSISCIII), Santiago de Compostela, Spain (CFM, JSC, MAS, FG); Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain (ED, EMT); Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (CFM, FG); and Concepción Arenal Primary Care Center, Santiago de Compostela, Spain (FG).
Edelmiro Menéndez-TorreFrom the Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain (TGV, JA, ED, EMT); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain (TGV, JA, ED, EMT); Department of Medicine, University of Oviedo, Spain (TGV, JA, ED, EMT); Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS, ÓLB, FG); Santiago de Compostela, Spain (OLB, CFM, JSC, MAS); ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain (OLB); A Estrada Primary Care Center, A Estrada, Spain (CFM, JSC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPSISCIII), Santiago de Compostela, Spain (CFM, JSC, MAS, FG); Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain (ED, EMT); Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (CFM, FG); and Concepción Arenal Primary Care Center, Santiago de Compostela, Spain (FG).
Francisco GudeFrom the Department of Endocrinology and Nutrition, Hospital Universitario Central de Asturias/University of Oviedo, Spain (TGV, JA, ED, EMT); Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain (TGV, JA, ED, EMT); Department of Medicine, University of Oviedo, Spain (TGV, JA, ED, EMT); Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS, ÓLB, FG); Santiago de Compostela, Spain (OLB, CFM, JSC, MAS); ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela, Spain (OLB); A Estrada Primary Care Center, A Estrada, Spain (CFM, JSC); Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPSISCIII), Santiago de Compostela, Spain (CFM, JSC, MAS, FG); Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain (ED, EMT); Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (CFM, FG); and Concepción Arenal Primary Care Center, Santiago de Compostela, Spain (FG).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere are no studies on the clinical significance of asymptomatic hypoglycemia detected incidentally during routine testing.

methodsBaseline fasting serum glucose was determined in 1333 individuals without diabetes (43.3% males, median age 50 years, range 18 to 91 years) to investigate the prevalence of hypoglycemia (fasting serum glucose <70 mg/dL) and the associated demographic, lifestyle, and metabolic factors. Individuals with baseline hypoglycemia were followed (median follow-up, 8.7 years) and assessed for hypoglycemia symptoms. Seven-day continuous glucose monitoring was performed in a subsample of 489 individuals.

resultsBaseline hypoglycemia was observed in 20 individuals (weighted prevalence, 1.58%, 95% confidence interval 0.87%-2.28%). Hypoglycemia was mild and asymptomatic in all cases (median, 67 mg/dL, range 63 to 69 mg/dL). The characteristics of those with hypoglycemia were similar to those with fasting serum glucose 70 to 80 mg/dL. Hypoglycemia was associated with female sex, younger age, and a more favorable metabolic profile (lower body mass index, glycohemoglobin and insulin resistance) than individuals with fasting serum glucose >80 mg/dL. Individuals with baseline hypoglycemia showed no distinct hypoglycemia features in continuous glucose monitoring (n = 9). During follow-up (n = 19), hypoglycemia in routine determinations, always mild, recurred in 42.1% of individuals, although the mean of successive glucose concentrations was higher than baseline in all cases. None of the individuals had symptoms that could constitute Whipple's triad (low serum glucose, symptoms of hypoglycemia, and symptomatic improvement after correction of hypoglycemia) during the follow-up period.

conclusionsDetection of asymptomatic, mild hypoglycemia in routine blood tests is not indicative of disease and does not require further investigation.

Indexed as

Blood GlucoseFastingHypoglycemiaAdolescentAdultAgedAged, 80 and overAsymptomatic DiseasesFemaleFollow-Up StudiesHumansMaleMiddle AgedOutpatientsPrevalenceYoung AdultBlood GlucoseAsymptomatic ConditionsContinuous Glucose MonitoringEndocrinologyHypoglycemiaPrimary Health Care

Identifiers

PMID40789619
PMCPMC12616800

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.