Insulinoma causing hypoglycemia in a patient with type 2 diabetes.
Insulinoma in a patient with pre-existing diabetes is extremely rare. A 74-year-old woman with type 2 diabetes mellitus who had been treated with a sulfonylurea for 6 years began experiencing frequent episodes of hypoglycemia. Endogenous hyperinsulinism was found 9 months after the sulfonylurea was discontinued, and transabdominal ultrasonography and magnetic resonance imaging identified a pancreatic tumor. Pathology examination of the resected tumor demonstrated an insulinoma. Postoperatively, the patient had no further episodes of hypoglycemia. Thereafter, she required insulin to control her hyperglycemia. Although hypoglycemic agents are the commonest cause of hypoglycemia in type 2 diabetes, insulinomas may occur in these patients. This possibility should be considered if the hypoglycemia persists despite dose adjustment or cessation of the drugs.
Lei
Wei-Yi
WY
Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, Taipei, Taiwan.
Wang
Tsang-En
TE
Chen
Tien-Ling
TL
Chang
Wen-Hsiung
WH
Yang
Tsen-Long
TL
Wang
Cheng-Yi
CY
D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005907:Gliclazide / Q000627:therapeutic use; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology; D007003:Hypoglycemia / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007340:Insulinoma / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014463:Ultrasonography
D007004:Hypoglycemic Agents; D005907:Gliclazide