Dual aetiologies for hyperinsulinaemic hypoglycaemia in one patient.

To the Editor—We read with interest the articles by Ching et al1 and Ma.2 We agree with Ching et al’s recommendation that health care providers should be vigilant to the problem of hypoglycaemia due to inadvertent use of oral hypoglycaemic agents (OHA), and are encouraged to see the increased availability of urine toxicology services for detection of OHA in Hong Kong after the cluster of iatrogenic hypoglycaemia incidents in May 2005.3 However, we also wish to highlight the importance of not overlooking other treatable causes of hypoglycaemia, even in the presence of positive toxicology, by sharing with readers the following case.