Spontaneous hypoglycaemia in a noninsulin-dependent diabetes mellitus patient with disseminated pancreatic carcinoma.
A 52-year-old-woman with non-insulin-dependent diabetes mellitus developed carcinoma of the pancreas and had a Whipple's resection performed. She required pancreatic exocrine supplements and insulin post-operatively. Five years later metastatic disease became apparent, and was accompanied by episodic spontaneous hypoglycaemia necessitating the cessation of insulin therapy. Hormonal analysis was performed, off insulin, at a time of hypoglycaemia (glucose 0.9 mmol l-1) and showed negligible insulin concentrations (< 2 mU l-1) but raised IGF-II together with low IGF-I concentrations (1.85 and 0.1 U ml-1, respectively). The association between diabetes and pancreatic carcinoma, and the pathogenesis of non-islet cell tumour induced hypoglycaemia (NICTH) are discussed.
Sturrock
N D
ND
Department of Diabetes and Endocrinology, City Hospital, Nottingham, UK.
Selby
C
C
Hosking
D J
DJ
D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D007328:Insulin / Q000627:therapeutic use; D007335:Insulin-Like Growth Factor II / Q000032:analysis / Q000378:metabolism; D008875:Middle Aged; D010187:Pancreatic Hormones / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000503:physiopathology / Q000556:secondary; D016577:Pancreaticoduodenectomy
D007328:Insulin; D010187:Pancreatic Hormones; D007335:Insulin-Like Growth Factor II