Clinical features

Why?

• Patients with insulin-dependent diabetes are not good at judging whether they are hypoglycaemic : sensitivity 55% (95% CI: 45% to 65%) c

Altered mental state: absence of hypoglycaemic symptoms does not exclude hypoglycaemia

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability	LR- (95% CI)	Post-test Probability
altered mental state c (pre-test probability: 9%)	hypoglycaemia (blood glucose or clinical diagnosis)	any of tachycardia, sweating or available history of diabetes mellitus	1.7 (1.3 to 2.1)	14%	0.45 (0.23 to 0.86)	4%

Diabetes: absence of hypoglycaemic symptoms does not exclude hypoglycaemia

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability	LR- (95% CI)	Post-test Probability
insulin-dependent diabetes mellitus c (pre-test probability: 6%)	hypoglycaemia (blood glucose < 3 mmol/l)	symptoms of hypoglycaemia	8.3 (6.5 to 10.5)	35%	0.56 (0.48 to 0.66)	3%