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...
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doaj-6ec1e95f3d944e56bc9d6d0b509491052021-04-30T07:23:18ZengElsevierAACE Clinical Case Reports2376-06052019-11-0156e375e379Nesidioblastosis in an Adult with Short Gut Syndrome and Type 2 DiabetesMimi Wong, BSc, MBBS(Hons)0Luke Conway, MBBS, FRACP1Caroline Cooper, MBBS(Hons), FRCPA2Ashim Sinha, MD, FRACP, FACE3Nirjhar Nandi, FRACP4Address correspondence to Dr. Mimi Wong, Department of Medicine, 165 Esplanade, Cairns City, QLD, 4870 Australia.; From Department of Diabetes and Endocrinology, Cairns Hospital, Queensland, Australia; School of Medicine, University of Queensland, AustraliaFrom Department of Diabetes and Endocrinology, Cairns Hospital, Queensland, AustraliaSchool of Medicine, University of Queensland, Australia; Pathology Queensland, Princess Alexandra Hospital, Queensland, AustraliaFrom Department of Diabetes and Endocrinology, Cairns Hospital, Queensland, Australia; Department of Medicine, James Cook University, Queensland, Australia.From Department of Diabetes and Endocrinology, Cairns Hospital, Queensland, AustraliaABSTRACT: 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.http://www.sciencedirect.com/science/article/pii/S2376060520300407 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mimi Wong, BSc, MBBS(Hons) Luke Conway, MBBS, FRACP Caroline Cooper, MBBS(Hons), FRCPA Ashim Sinha, MD, FRACP, FACE Nirjhar Nandi, FRACP |
spellingShingle |
Mimi Wong, BSc, MBBS(Hons) Luke Conway, MBBS, FRACP Caroline Cooper, MBBS(Hons), FRCPA Ashim Sinha, MD, FRACP, FACE Nirjhar Nandi, FRACP Nesidioblastosis in an Adult with Short Gut Syndrome and Type 2 Diabetes AACE Clinical Case Reports |
author_facet |
Mimi Wong, BSc, MBBS(Hons) Luke Conway, MBBS, FRACP Caroline Cooper, MBBS(Hons), FRCPA Ashim Sinha, MD, FRACP, FACE Nirjhar Nandi, FRACP |
author_sort |
Mimi Wong, BSc, MBBS(Hons) |
title |
Nesidioblastosis in an Adult with Short Gut Syndrome and Type 2 Diabetes |
title_short |
Nesidioblastosis in an Adult with Short Gut Syndrome and Type 2 Diabetes |
title_full |
Nesidioblastosis in an Adult with Short Gut Syndrome and Type 2 Diabetes |
title_fullStr |
Nesidioblastosis in an Adult with Short Gut Syndrome and Type 2 Diabetes |
title_full_unstemmed |
Nesidioblastosis in an Adult with Short Gut Syndrome and Type 2 Diabetes |
title_sort |
nesidioblastosis in an adult with short gut syndrome and type 2 diabetes |
publisher |
Elsevier |
series |
AACE Clinical Case Reports |
issn |
2376-0605 |
publishDate |
2019-11-01 |
description |
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. |
url |
http://www.sciencedirect.com/science/article/pii/S2376060520300407 |
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