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
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.
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BibTeX
@article{akaoka2026insulinoma,
title = {{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}},
author = {Hiroaki Akaoka and Junko Sasaki and Yusuke Hirota and Takaya Matsushita and Ryo Suzuki},
journal = {Internal Medicine},
year = {2026},
month = aug,
doi = {10.2169/internalmedicine.7459-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7459-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - 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
AU - Hiroaki Akaoka
AU - Junko Sasaki
AU - Yusuke Hirota
AU - Takaya Matsushita
AU - Ryo Suzuki
PY - 2026
DA - 2026/08/08
JO - Internal Medicine
DO - 10.2169/internalmedicine.7459-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_7459-26/_article
AB - 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.
SN - 1349-7235
SN - 0918-2918
ER -