RESUMEN
Insulinoma is a rare neuroendocrine tumor originating from pancreatic beta cells, which clinically manifests Whipple′ s triad and recurrent hypoglycemia. Insulinoma in a patient with type 2 diabetes mellitus is even a more rarely encountered case. In clinical practice, hypoglycemia in patients with diabetes is often considered to be associated with oral hypoglycemic agents, but insulinoma, as a possible etiology, is usually neglected. This article reported a case of a patient with type 2 diabetes mellitus, before the diagnosis of which she had experienced recurrent hypoglycemia for about 14 years. Hypoglycemia symptoms with hyperinsulinemia kept existing even after the withdrawal of antidiabetic agents. The pancreatic imaging and postoperative histopathology supported the diagnosis of insulinoma. After surgery, plasma glucose level of the patient increased and diabetes treatments continued. The co-existence of insulinoma and type 2 diabetes mellitus in this case may be attributed to the insulin resistance induced by chronic hyperinsulinemia due to insulinoma.
RESUMEN
Insulinoma is a rare neuroendocrine tumor originating from pancreatic beta cells, which clinically manifests Whipple' s triad and recurrent hypoglycemia. Insulinoma in a patient with type 2 diabetes mellitus is even a more rarely encountered case. In clinical practice, hypoglycemia in patients with diabetes is often considered to be associated with oral hypoglycemic agents, but insulinoma, as a possible etiology, is usually neglected. This article reported a case of a patient with type 2 diabetes mellitus, before the diagnosis of which she had experienced recurrent hypoglycemia for about 14 years. Hypoglycemia symptoms with hyperinsulinemia kept existing even after the withdrawal of antidiabetic agents. The pancreatic imaging and postoperative histopathology supported the diagnosis of insulinoma. After surgery, plasma glucose level of the patient increased and diabetes treatments continued. The co-existence of insulinoma and type 2 diabetes mellitus in this case may be attributed to the insulin resistance induced by chronic hyperinsulinemia due to insulinoma.