Admission or observation for oral anti-hyperglycemic agent or intermediate- to long-acting insulin. Consider discharge after 4h uneventful observation if:<unk>  fully and rapidly reversed without continuous infusion of dextrose
Tolerated a full meal in ED
Clear and innocuous cause identified with recurrence unlikely
Adequate patient understanding, home support/monitoring, and ability to detect/prevent recurrence with close primary care follow-up
Admission for 48-72 hrs of monitored fasting with q4 BGLs, insulin, C-peptide, proinsulin
Then localization studies with US, CT, or MRI
Hypoglycemia
Anti-hyperglycemic
Nonketotic hyperglycemia
Insulin
Ketonemia
Oral secretagogue
Hyperammonemia
Sulfonylurea toxicity