Insulinoma Combined with Type 2 Diabetes Mellitus：A Case Report and Literature Review

doi:10.3969/j.issn.1007-9572.2016.29.027

Abstract

Abstract: Insulinoma is a neuroendocrine tumor originating from pancreatic beta cells，which clinically manifests Whipple’s triad，especially recurrent hypoglycemia.Insulinoma accompanied by diabetes mellitus is very rare.The hypoglycemia，is often wrongly attributed to the effects of hypoglycemic agents，which makes diagnosis particularly challenging.This article reported the case of a diabetic patient with two years’ recurrent hypoglycemia，without injecting exogenous insulin.Whipple’s triad accompanied by hyperinsulinemia and high C-peptide levels kept existing after discontinuation of hypoglycemic agents.The pancreatic imaging and postoperative histopathology confirmed the diagnosis of insulinoma.The patient had persistent hyperglycemia and required long-term insulin treatment after operation.

Key words: Insulinoma, Diabetes mellitus, type 2, Hypoglycemia

摘要： 胰岛素瘤是一种来源于胰岛β细胞的神经内分泌肿瘤，临床表现为反复发作的低血糖症，典型的Whipple三联征。糖尿病合并胰岛素瘤非常罕见，经常被认为是降糖药物引起低血糖症，故容易漏诊、误诊。本文报道1例2型糖尿病患者间断出现低血糖症2年，未注射外源性胰岛素，停用降糖药物后仍有Whipple三联征伴高胰岛素血症、高C肽水平，胰腺影像学和术后病理支持胰岛素瘤诊断，术后患者血糖水平持续升高，需长期胰岛素降糖治疗。

关键词: 胰岛素瘤, 糖尿病, 2型, 低血糖症

GAO Hai-na, TANG Yong, HE Xue-feng, CHEN Shu-chun, SONG Guang-yao. Insulinoma Combined with Type 2 Diabetes Mellitus：A Case Report and Literature Review[J]. Chinese General Practice, 2016, 19(29): 3634-3637.

高海娜, 唐勇, 何学峰, 陈树春, 宋光耀. 2型糖尿病合并胰岛素瘤一例报道并文献复习[J]. 中国全科医学, 2016, 19(29): 3634-3637.

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