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Insulinoma in a patient with NIDDM
L A Kane1, C S Grant, T B Nippoldt
1Department of Internal Medicine, Mayo Medical School, Rochester, MN 55905.
Objective:
To confirm insulinoma as the cause of hypoglycemia in a patient with NIDDM and determine the frequency of the co-occurrence of these two conditions.
Research Design And Methods:
The patient underwent an in-hospital prolonged fast (< or = 72 h), according to standard protocol, and an ultrasound examination of the pancreas. All cases of histologically confirmed insulinoma at this institution over the period of 1927-1992 were reviewed to determine the prevalence of pre-existent diabetes mellitus.
Results:
After 10 h of fasting, plasma glucose was low (1.89 mM); plasma insulin (258 pM) and C-peptide (1.39 nM) were elevated in the absence of sulfonylurea in the plasma. An insulinoma detected by ultrasonography was removed surgically with subsequent reoccurrence of insulin-requiring diabetes. Among 313 cases of insulinoma confirmed at this institution, this patient is the only one with pre-existent diabetes mellitus.
Conclusions:
Insulinoma occurs extraordinarily rarely in patients with pre-existing NIDDM.