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Pre‐ and Postoperative Glucose Levels for Eliciting Hypoglycaemic Responses in a Patient with Insulinoma
Author(s) -
Vea H.,
Jorde R.,
Sager G.,
Vaaler S.,
Sundsfjord J.,
Revhaug A.
Publication year - 1992
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1992.tb01738.x
Subject(s) - medicine , insulinoma , endocrinology , plasma glucose , insulin , hypoglycemia , epinephrine , hormone , sweat
Counterregulatory hormones and hypoglycaemic symptoms were studied during a gradual decline in plasma glucose in a 66‐year‐old man before and 9 weeks after removal of an insulin‐producing tumour. Before surgery the adrenaline started to respond first at plasma glucose 2.8 mmol I −1 . He reported no autonomic symptoms although plasma glucose fell to 2.3 mmol I −1 with a corresponding adrenaline rise to 4.64 nmol I −1 . After surgery adrenaline responded at a plasma glucose of 3.7 mmol I −1 and he started to sweat and tremble at a plasma glucose of 3.1 mmol I −1 (corresponding adrenaline 2.63 nmol I −1 ). The lack of autonomic symptoms preoperatively may indicate adrenaline insensitivity, possibly as a result of repeated hypoglycaemia.