title: Octreotide-treated diabetes accompanied by endogenous hyperinsulinemic hypoglycemia and protein-losing gastroenteropathy.
abstract: Occurrence of hypoglycemia in diabetes patients is very rare. We report here a case of frequent hypoglycemic attacks caused by inappropriate endogenous hyperinsulinemia in a female patient with poorly controlled diabetes and protein-losing gastroenteropathy. The blood glucose profiles of the patient were unstable. Results of the fasting test performed to investigate the cause of hypoglycemia suggested endogenous hyperinsulinism. Repeated selective arterial calcium injection tests suggested that hyperinsulinemia might be extrapancreatic in origin. However, efforts to detect a responsible lesion such as insulinoma were unsuccessful. Octreotide was used for the treatment of hypoglycemia and protein-losing gastroenteropathy. After treatment, although her leg edema caused by hypoalbuminemia persisted, hypoglycemia almost disappeared.
authors.affiliation: Department of Internal Medicine, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Toubetsu, Hokkaido 061-0293, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Takahashi
authors.forename: Miho
authors.initials: M
authors.lastname: Nagamine
authors.forename: Mitsuko
authors.initials: M
authors.lastname: Fukuda
authors.forename: Wataru
authors.initials: W
authors.lastname: Motomura
authors.forename: Atsuko
authors.initials: A
authors.lastname: Abiko
authors.forename: Masakazu
authors.initials: M
authors.lastname: Haneda
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Fujiya
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ieko
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo