title: Insulinoma induced hypoglycemia in a type 2 diabetic patient.
abstract: Insulinoma in a patient with pre-existing diabetes mellitus is extremely rare. We report a case of an insulinoma in a patient with type 2 diabetes mellitus who after 14 years of sulfonylurea treatment experienced recurrent episodes of hypoglycemia. Endogenous hyperinsulinism was confirmed and endoscopic ultrasonography identified a pancreatic tumor, which was positive for insulin by immuno-histological staining. After surgical excision of the tumor, no further hypoglycemic attacks occurred. Loss of body weight after removal of the tumor correlated with a dramatic reduction of insulin resistance to such a degree that diet alone proved sufficient for satisfactory glycemic control.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre, Ljubljana, Slovenia. maja.ravnik@kclj.si
authors.forename: M
authors.initials: M
authors.lastname: Ravnik-Oblak
authors.forename: A
authors.initials: A
authors.lastname: Janez
authors.forename: A
authors.initials: A
authors.lastname: Kocijanicic
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology; D007003:Hypoglycemia / Q000209:etiology*; D007333:Insulin Resistance; D007340:Insulinoma / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography