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Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
[Hypoclycaemia in a diabetic man's wife]
1Departement Medizin, Luzerner Kantonsspital, Luzern. christoph.henzen@luks.ch
Abstract:
Insulinoma are rare tumours with an incidence of 4/100'000, supposedly hypoglycaemic symptoms, however, are often attributed to people without diabetes mellitus. The many different causes of hypoglycaemic disorders are best classified in whether occurring in healthy-appearing or ill patients. Patient's history and physical examination allow to substantiate the suspected hyperinsulinaemic hypoglycaemia which need to be proven in the 72-hour fast to meet the Whipple triad, i. e. low plasma glucose <= 2.5 mmol/l and neuroglycopenic symptoms and relief after ingesting glucose. In the next step localisation of the suspected insulinoma and exclusion of non-insulinoma pancreatogenous hypoglycaemia is aimed at. GLP-1 receptor scintigraphy, a recent and sensitive method to localize insulinoma, proved reliable in the presented case report.
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