Hypoglycemia Caused by Endogenous Hyperinsulinism: A Case Study

Abstract

Hypoglycemia in the absence of diabetes mellitus in a healthy individual needs’ evaluation. We report a case of 45 years old female who presented with restlessness, anxiety, palpitations, excessive sweating followed by dizziness, and tremors in her hand. Eating sugar or consuming glucose water alleviated symptoms. During one such episode, the patient was taken to a nearby clinic and her capillary blood glucose was 43 mg/dl. The patient was admitted for the 72 hours supervised fast after ruling out other systemic causes of hypoglycemia. Evaluation of critical sample showed elevated levels of insulin, c-peptide, proinsulin, as well as a decreased value of beta-hydroxybutyrate and a negative urine screen for oral anti-diabetic agents, a diagnosis of endogenous hyperinsulinism, was made.