‘Inappropriate’ Insulin Secretion (2) Factitious hypoglycaemia is associated with inappropriate hyperinsulinaemia during hypoglycaemic episodes, but is distinguished from endogenous hyperinsulinaemia by the associated appropriately low plasma C-peptide levels. All other types of spontaneous hypoglycaemia, apart from sulphonylurea poisoning and some forms of autoimmune hypoglycaemia, occur in conjunction with appropriately low plasma insulin and C-peptide concentrations. See later: • Plasma C-peptide Assay