Abstract

Non diabetic hypoglycemia (or endogenous hypoglycemia) is an uncommon clinical problem, their study and treatment are a complex process. Under normal physiologic conditions, counterregulatory mechanisms prevent hypoglycemia. The use (involuntary or prescribed) of drugs associated with hypoglycemia (meglitinides, sulfonylureas and insulin) must always be ruled out. In healthy patients the main cause is an insulinoma (a type of neuroendocrine pancreatic tumor) and demands multidisciplinary management. The key for the diagnosis of insulinoma is the Whipple’s triad described in 1930 by Allen Whipple (an American surgeon); symptoms occur during fasting or exercise, and are weird after eating. Surgical treatment is usually the only curative option. We aim to improve the diagnosis approach and our comprehension about these rare cases in clinical practice. Below we present a clinical case of a 51-year-old female patient with no history of diabetes admitted to our institution due to persistent hypoglycemia.

Keywords

Hypoglycemia, diabetes mellitus, insulinoma, pancreatic neuroendocrine tumor, hyperinsulinism