Organic Hyperinsulinism and Hypoglycemia due to Coexistence of Islet Cell Adenomatosis, Nesidioblastosis, and Hyperplasia in a Patient with Type 2 Diabetes

Abstract

Hypoglycemia due to organic hyperinsulinism in previously diabetic patients is very rare. In most of these cases, insulin producing adenomas are the cause of the hyperinsulinism. We report, to our knowledge, the first case of hypoglycemia due to hyperinsulinism caused by the coexistence of islet cell hyperplasia, nesidioblastosis and adenomatosis occurring in the setting of type 2 diabetes. These histologic findings are included in the spectrum of the so-called beta cell dysmaturation syndrome. We speculate on the possible pathophysiological interactions between these two seemingly opposite disorders.