title: A rare cause of hypoglycemia in a type 2 diabetic patient: insulinoma.
abstract: Recurrent episodes of hypoglycemia in patients with diabetes are often associated with the ongoing treatment regimen. However, despite changes in treatment modalities, assessment of the causes of hypoglycemia in nondiabetic patients in the presence of severe and recurrent hypoglycemia is very important. The treatment that had been provided for 6 years in a 67-year-old female patient with type 2 diabetes mellitus was discontinued due to hypoglycemic episodes that presented for the previous 2 years. The patient experienced persistent hypoglycemia after cessation of the treatment and was hospitalized for further examination. Spontaneous hypoglycemia with a final diagnosis of insulinoma was established following histopathologic evaluation and was relieved postoperation. Insulinoma is rarely encountered as a cause of hypoglycemia in patients with type 2 diabetes. Insulin-secreting tumors should be considered where hypoglycemic episodes occur despite discontinuation of insulin and other antidiabetic treatment with endogenous hyperinsulinemia being noncompliant with the blood glycemic levels.
authors.affiliation: Department of Endocrinology and Metabolism, Uludag University Medical School, Bursa, Turkey. drcander@gmail.com
authors.forename: Soner
authors.initials: S
authors.lastname: Cander
authors.forename: Ozen Öz
authors.initials: OÖ
authors.lastname: Gül
authors.forename: Nalan
authors.initials: N
authors.lastname: Yıldırım
authors.forename: Oğuz Kaan
authors.initials: OK
authors.lastname: Unal
authors.forename: Ozlem
authors.initials: O
authors.lastname: Saraydaroğlu
authors.forename: Sazi
authors.initials: S
authors.lastname: Imamoğlu
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood / Q000209:etiology*; D007003:Hypoglycemia / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D007340:Insulinoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds