A Case Report: Hypoglycaemic Unawareness Associated With Insulinoma

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2024 Aug 20

PMID 39161528

Authors

Alamin Alkundi

Rabiu Momoh

Affiliations

Soon will be listed here.

Abstract

Hypoglycaemic unawareness (HU) is more frequently described in relation to diabetics in the literature. We have noted that there is also an increasing reporting of HU in insulinoma cases. We report a hospital presentation for an incidental finding of hypoglycaemic unawareness in a gentleman in his fifties who was eventually diagnosed with insulinoma following biochemical studies, radiologic evaluation and histologic evaluation of an excised lesion between the pancreas and the spleen. We have reviewed existing literature evidence regarding the possible aetiologies and management options for this occurrence. More research studies to identify the epidemiology of this association and the determination of a protocol for increased detection of patients with insulinoma who display HU will need to be done.

References

Nosakova L, Banovcin P, duricek M, Uhrik P, Bozikova J, Demeter M . Phenomenon of hypoglycemia unawareness in patients with insulinoma - single center experience. Neuro Endocrinol Lett. 2022; 42(8):522-527. View

Christesen H, Brusgaard K, Beck Nielsen H, Brock Jacobsen B . Non-insulinoma persistent hyperinsulinaemic hypoglycaemia caused by an activating glucokinase mutation: hypoglycaemia unawareness and attacks. Clin Endocrinol (Oxf). 2008; 68(5):747-55. DOI: 10.1111/j.1365-2265.2008.03184.x. View

Aida A, Noto H . Diagnosis and Treatment Course of Insulinoma Presenting as Hypoglycemia Unawareness Using a Factory-Calibrated Continuous Glucose Monitoring System. Am J Case Rep. 2022; 23:e936723. PMC: 9350881. DOI: 10.12659/AJCR.936723. View

Lo C, Sun D . A case of low serum insulin levels in a patient with insulinoma. Endocrinol Diabetes Metab Case Rep. 2016; 2016. PMC: 4992050. DOI: 10.1530/EDM-16-0041. View

Ferreira A, Serino Barbosa M, Coelho R, Lourenco P . Asymptomatic Hyperinsulinaemic Hypoglycaemia. Eur J Case Rep Intern Med. 2020; 7(10):001827. PMC: 7546560. DOI: 10.12890/2020_001827. View

Sugawa T, Murakami T, Yabe D, Kashima R, Tatsumi M, Ooshima S . Hypoglycemia Unawareness in Insulinoma Revealed with Flash Glucose Monitoring Systems. Intern Med. 2018; 57(23):3407-3412. PMC: 6306522. DOI: 10.2169/internalmedicine.1173-18. View

Mitrakou A, Fanelli C, Veneman T, Perriello G, Calderone S, Platanisiotis D . Reversibility of unawareness of hypoglycemia in patients with insulinomas. N Engl J Med. 1993; 329(12):834-9. DOI: 10.1056/NEJM199309163291203. View

Okabayashi T, Shima Y, Sumiyoshi T, Kozuki A, Ito S, Ogawa Y . Diagnosis and management of insulinoma. World J Gastroenterol. 2013; 19(6):829-37. PMC: 3574879. DOI: 10.3748/wjg.v19.i6.829. View

Martin-Timon I, Del Canizo-Gomez F . Mechanisms of hypoglycemia unawareness and implications in diabetic patients. World J Diabetes. 2015; 6(7):912-26. PMC: 4499525. DOI: 10.4239/wjd.v6.i7.912. View

10.

Nakajima R, Idesawa H, Sato D, Ito J, Ito K, Fujii M . Continuous glucose monitoring in a patient with insulinoma presenting with unawareness of postprandial hypoglycemia. Endocrinol Diabetes Metab Case Rep. 2023; 2023(3). PMC: 10563612. DOI: 10.1530/EDM-23-0056. View

11.

Matsumoto K, Watanabe M, Takao K, Takahashi H, Daido H, Shibata T . Unmasked insulinoma occasioned by severe hypoglycemic coma immediately postpartum: a case report. BMC Endocr Disord. 2023; 23(1):168. PMC: 10413590. DOI: 10.1186/s12902-023-01415-1. View