SPONTANEOUS HYPOGLYCEMIA IN A NON-INSULIN-DEPENDENT DIABETES-MELLITUSPATIENT WITH DISSEMINATED PANCREATIC-CARCINOMA

A 52-year-old-woman with non-insulin-dependent diabetes mellitus devel oped carcinoma of the pancreas and had a Whipple's resection performed , She required pancreatic exocrine supplements and insulin post-operat ively. Five. years later metastatic disease became apparent, and was a ccompanied by episodic spontaneous hypoglycaemia necessitating the ces sation of insulin therapy, Hormonal analysis was performed, off insuli n, at a time of hypoglycaemia (glucose 0.9 mmol l(-1)) and showed negl igible insulin concentrations (<2 mU l(-1)) but raised IGF-II together with low IGF-I concentrations (1.85 and 0.1 U ml(-1), respectively). The association between diabetes acid pancreatic carcinoma, and the pa thogenesis of non-islet cell tumour induced hypoglycaemia (NICTH) are discussed.