NESIDIOBLASTOSIS IN AN ADULT WITH SHORT GUT SYNDROME AND TYPE 2 DIABETES.

Abstract

OBJECTIVE:

Adult nesidioblastosis is characterized by endogenous hyperinsulinemia typically causing post-prandial hypoglycemia, and most commonly occurs post-Roux-en-Y gastric bypass.

METHODS:

We report a unique case of nesidioblastosis occurring in a 67-year-old female.

RESULTS:

A 5-year history of symptomatic hypoglycemia occurred in a patient with short bowel syndrome and type 2 diabetes mellitus (T2DM) managed previously with a glucagon-like peptide 1 (GLP-1) agonist, which achieved significant weight loss. Continuous glucose monitoring captured 42 hypoglycemia episodes in a 2-week period, and following an oral glucose tolerance test there was the suggestion of a hyperinsulinemia state. She was managed with an open distal pancreatectomy, and subsequently required medical therapy to maintain euglycemia.

CONCLUSION:

We present the first case of nesidioblastosis occurring in a patient with short bowel syndrome, pre-existing T2DM managed with a GLP-1 agonist which achieved significant weight loss, all of which we speculate could have predisposed to hypoglycemia and development of nesidioblastosis.

• Authors: Mimi Wong, Luke Conway, Caroline Cooper, Ashim Sinha, Nirjhar Nandi
• Journal: AACE clinical case reports (AACE Clin Case Rep) 2019 Nov-Dec Vol. 5 Issue 6 Pg. e375-e379 ISSN: 2376-0605 [Electronic] United States
• PMID: 31967075 (Publication Type: Case Reports)
• Copyright: Copyright © 2019 AACE.