A case of insulinoma successfully treated with diazoxide. Investigation with an artificial islet.:Investigation with an Artificial Islet
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An insulinoma patient who frequently suffered from severe hypoglycemic attacks wasadministereddiazoxide preoperatively to treat his hypoglycemia. The usefulness of this treatment in controllingblood glucose was confirmed by an artificial islet.<BR>The patient was a 70-year-old male. At 68 he began to experience attacks of unconsciousnessand was hospitalized in our department because of suspicion of insulinoma. The fasting bloodglucose was 12mg/d<I>l</I> and the WI was 16 μU/m<I>l</I>.<BR>After admission the hypoglycemic attacks persisted in spite of regular food intake. Intravenoushyperalimentation was initiated and diazoxide, 200mg/day p. o., was given to maintain the patient'sgeneral condition until surgery.<BR>The effect of preoperative diazoxide in increasing blood glucose was quantified byusing anartificial islet to calculate the daily amount of i. v. glucose (from 2 pm to 8 am) required to maintainthe blood glucose at 80mg/d<I>l</I> under a calory intake of 2000 Cal. Prior to diazoxide treatment, 102g of i. v. glucose was required, while only 38g was necessary postoperatively, demonstrating theeffectiveness of diazoxide in maintaining an adequate blood glucose level.<BR>After surgical removal of two-thirds of the tail of the pancreas, a tumor measuring 10mm indiameter and two rice-grain-size tumors were found. The tumor insulin content was 17.8 U/wt.g. Gel filtration revealed that 72.4% was high molecular weight insulin. The patient's postoperativecourse was favorable with no hypoglycemic attacks.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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