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Endocr Pract. 1998 Mar-Apr;4(2):94-5.

Spontaneous hypoglycemia associated with congestive heart failure attributable to hyperinsulinism.

Author information

1
Memorial Medical Center, Savannah, Georgia, USA.

Abstract

OBJECTIVE:

To report a case of spontaneous hypoglycemia associated with congestive heart failure in an adult.

METHODS:

We describe a 72-year-old man in whom profound hypoglycemia (serum glucose level, 21 mg/dL) developed during an exacerbation of heart failure. Clinical and laboratory data are reviewed.

RESULTS:

An inverse relationship was found between both serum insulin and C peptide levels and serum glucose level. Serum glipizide and glyburide levels were undetectable, and no insulinoma was found on radiologic imaging. Hypoglycemia resolved after alleviation of the congestive heart failure.

CONCLUSION:

In this case, the hypoglycemia was attributed to hyperinsulinemia. Possible mechanisms include impaired insulin degradation and shunting of portal blood into the systemic circulation.

PMID:
15251753
DOI:
10.4158/EP.4.2.94

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