Insulinoma in Type 2 Diabetes Mellitus Becoming Clinically Evident in the Setting of Acute Kidney Injury: A Case with a Postoperative Deterioration of the Glucose Metabolism and a Quantitative Islet Cell Analysis
Year: 2026
Type: article
Study design: Case Report
Abstract: Insulinoma rarely coexists with type 2 diabetes mellitus and it may thus remain clinically unrecognized. We describe a case of a 73-year-old man with long-standing type 2 diabetes mellitus in whom recurrent hypoglycemia became evident during progressive renal dysfunction after acute kidney injury. Following an aneurysm repair and distal pancreatectomy, hypoglycemia resolved, but his glucose metabolism deteriorated markedly. A quantitative analysis of non-tumorous pancreatic tissue revealed an intermediate β-cell area and a relatively increased α-cell area. A postoperative glucose deterioration is likely multifactorial, reflecting distal pancreatectomy, long-standing diabetes with limited β-cell reserve, and chronic renal dysfunction. This case highlights the complexity of the glucose metabolism in patients with insulinoma.
Source: Internal Medicine
Authors: Hiroaki Akaoka, Junko Sasaki, Yusuke Hirota, Takaya Matsushita, Ryo Suzuki
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7201888978