Insulin resistance with pancreatic pseudocyst relieved by percutaneous drainage

An insulin-requiring type 2 diabetic patient became insulin-resistant with development of a pancreatic pseudocyst following cholecystitis and cholecystectomy. Drainage of the cyst fluid was followed by rapid return to his prior insulin requirement. As there were no indications of insulin allergy, obesity, or hormonal imbalance, we postulate a subclinical state of pancreatitis that was relieved with drainage of the pseudocyst fluid.