Relativism in the diagnosis of hypoglycemia.

It is a common assumption in our medicalized society that diagnostic labels simply describe facts, rather than express the diagnostician's own concepts of anomaly and dysfunction. Variability among physicians in diagnosing reactive hypoglycemia illustrates some fundamental problems of reifying the concept of disease. Although most physicians consider the same three variables in this diagnosis, their interpretations of them may vary widely. The disagreement centers around the credibility given standardized, technological measures versus the individual patient's experiences. Most physicians consider lab tests definitive in diagnosing hypoglycemia, while bypassing patients' subjective reports. Some, however, rely more heavily on patient-generated criteria to diagnose the condition. This lack of agreement about the criteria for diagnosing hypoglycemia, coupled with the psychological nature of many of the symptoms, make hypoglycemia and psychological disorder reasonable alternative diagnoses. These diagnoses, in turn, have very different effects on patients. These variations in physicians' diagnostic criteria illustrate that diagnostic labels are cognitive constructs, subject to the influence of the physician's culture, expectations, values and interests.