Which of the following is not associated with hypoglycemia?

• A. Neuroglycopenia
• B. Symptoms occur with plasma glucose level of 60-70 mg/dL
• C. Decreased hepatic glucose production
• D. Diagnostic test is 72-hour fast

Answer: (B)

Hypoglycemia is defined by insufficient glucose supply to the brain and by metabolic responses that arise when blood glucose falls. Neuroglycopenia—brain glucose deprivation—produces symptoms such as confusion, visual disturbances, seizures, and coma, making it a classic feature of hypoglycemia. When the liver can’t release enough glucose due to decreased hepatic glucose production, the risk and presentation of hypoglycemia increase, so this connection is valid. A 72-hour fast is a standard diagnostic test used to provoke endogenous hypoglycemia in suspected cases of insulin excess or metabolism disorders, so it’s also a valid association.

The statement about symptoms occurring at a fixed plasma glucose level of 60–70 mg/dL is not a reliable universal rule. Symptom onset varies between individuals and can occur at higher or lower glucose levels depending on rate of decline, insulin levels, and counterregulatory responses. Therefore this specific range is not a consistently associated hallmark, making it the best choice for not being an inherent feature of hypoglycemia.