Insulinoma may mask the existence of Type 1 diabetes

Diabetic Medicine : a Journal of the British Diabetic Association
Y OikawaA Shimada

Abstract

Insulinoma is a tumour of insulin-producing cells of the pancreas and is known to be one of the causes of hypoglycaemia. Usually, appropriate removal of the insulinoma results in normalization of blood glucose levels. However, we found novel cases of insulinoma, in which hyperglycaemia developed soon after resection of the insulinoma. We encountered two patients with repeated hypoglycaemia caused by insulinoma. Following removal of the insulinoma, unanticipated hyperglycaemia was observed in both patients. Thereafter, their blood tests revealed low levels of serum C-peptide and high titres of anti-glutamic acid decarboxylase antibody, indicating concomitant Type 1 diabetes. Indeed, histological examination of the resected specimen revealed that one patient showed insulitis in non-tumorous pancreatic tissue in which β-cells had already disappeared. Moreover, inflammatory cells infiltrated the insulinoma, as if it were insulitis of Type 1 diabetes, suggesting the existence of anti-islet autoimmunity. These are first cases of insulinoma associated with underlying Type 1 diabetes. Physicians should be aware of the possibility that insulinoma may mask Type 1 diabetes, and measurement of anti-islet autoantibodies may be helpful to fi...Continue Reading

References

Feb 9, 2005·Annals of the New York Academy of Sciences·Eiji Kawasaki, Katsumi Eguchi
May 30, 2008·Endocrine-related Cancer·Thorvardur R HalfdanarsonGloria M Petersen
Jul 3, 2009·The Journal of Immunology : Official Journal of the American Association of Immunologists·Kelley ZwickerOliver F Bathe
Oct 9, 2009·Diabetologia·Y KawabataUNKNOWN Committee on Type 1 Diabetes, Japan Diabetes Society

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Citations

May 3, 2016·Diabetic Medicine : a Journal of the British Diabetic Association·T JoshiS Acharya
Jan 14, 2020·Molecular and Clinical Oncology·Constantinos NastosAndromachi Vryonidou
Sep 30, 2021·Journal of Medical Case Reports·Joseph SingboIan Louis Ross

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