Simultaneous presentation of an insulinoma and type 2 diabetes mellitus: A case report

Sarah Swarts, Aaron Sasson, Anthony Adelson, Whitney S Goldner

Research output: Contribution to journalReview article

Abstract

Hypoglycemia in the setting of diabetes mellitus is usually ascribed to the management of diabetes mellitus. Rarely, an additional etiology should be considered. We report a 35-year-old woman who presented with both type 2 diabetes mellitus and an insulinoma. She had a history of diet-controlled gestational diabetes and developed symptomatic fasting and nonfasting hypoglycemia immediately postpartum. She presented for evaluation of hypoglycemia 3 months postpartum. The episodes of hypoglycemia occurred during fasting with the lowest documented blood glucose being 2.16 mmol/L (39 mg/dL), but also occurred between meals and at night. Additionally, she also had many glucose values above 11.1 mmol/L (200 mg/dL) meeting the criteria for type 2 diabetes mellitus. A 72-hour fast led to a documented episode of symptomatic hypoglycemia accompanied by elevated insulin levels after 8 hours (glucose 2.3 mmol/L [42 mg/dL], 69.5 pmol/L [insulin 10 μIU/mL]). Abdominal computed tomography and abdominal ultrasound were normal, but pancreatic venous sampling localized a lesion in the distribution of the splenic artery, and intraoperative ultrasound revealed a 1.5-cm mass abutting the splenic artery. She underwent distal pancreatectomy, and pathology and immunohistochemistry showed an insulin-producing neuroendocrine tumor. After surgery, the hypoglycemia resolved and the patient had persistent hyperglycemia. This case describes the simultaneous presentation of both an insulinoma and type 2 diabetes mellitus before resection of the tumor.

Original languageEnglish (US)
Pages (from-to)340-343
Number of pages4
JournalEndocrinologist
Volume16
Issue number6
DOIs
StatePublished - Nov 1 2006

Fingerprint

Insulinoma
Hypoglycemia
Type 2 Diabetes Mellitus
Splenic Artery
Insulin
Postpartum Period
Diabetes Mellitus
Glucose
Pancreatectomy
Gestational Diabetes
Neuroendocrine Tumors
Hyperglycemia
Meals
Blood Glucose
Fasting
Immunohistochemistry
Tomography
Pathology
Diet
Neoplasms

Keywords

  • Diabetes mellitus 2
  • Hypoglycemia
  • Insulinoma

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Simultaneous presentation of an insulinoma and type 2 diabetes mellitus : A case report. / Swarts, Sarah; Sasson, Aaron; Adelson, Anthony; Goldner, Whitney S.

In: Endocrinologist, Vol. 16, No. 6, 01.11.2006, p. 340-343.

Research output: Contribution to journalReview article

Swarts, Sarah ; Sasson, Aaron ; Adelson, Anthony ; Goldner, Whitney S. / Simultaneous presentation of an insulinoma and type 2 diabetes mellitus : A case report. In: Endocrinologist. 2006 ; Vol. 16, No. 6. pp. 340-343.
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