EFFECTS OF OCTREOTIDE ON CIRCULATING ISLET B-CELL PRODUCTS IN ENDOGENOUS HYPERINSULINISM

The role of somatostatin analogues in the medical management of insuli nomas is unclear. We describe an elderly patient with clinical and bio chemical features of endogenous hyperinsulinism attributable to a beni gn islet B cell disorder whose incapacitating neuroglycopaenic symptom s responded dramatically to octreotide 50 mug subcutaneously at 2200 h each night. Octreotide suppressed inappropriate plasma concentrations of insulin thereby preventing fasting hypoglycaemia. Fasting concentr ations of proinsulin, and 32-33 split proinsulin, as determined by two -site monoclonal antibody-based immunoradiometric assays, were also su ppressed by octreotide.