Iatrogenic hypoglycemia in a patient with type 2 diabetes and Münchhausen syndrome
Abstract
The coexistence of insulinoma and type 2 diabetes is rare, however it is reported in the literature. Episodes of hypoglycemia in patients with type 2 diabetes are, to some extent, part of the disease due to the therapy and the use of all hypoglycemic drugs including diet intervention. However, persistent episodes require diagnosis even after discontinuation of diabetes therapy. We present a patient with iatrogenic hypoglycemia and type 2 diabetes in Münchhausen syndrome. The coexistence of type 2 diabetes and insulinoma was suspected in that patient but the clinical picture suggested exogenous administration of hypoglycemic drugs, which was finally confirmed. Factitious hypoglycemia was a symptom of mental disorders such as a Münchhausen syndrome.
Keywords: hypoglycemiainsulinomaMünchhausen syndrome
References
- Câmara-de-Souza AB, Toyoshima MTK, Giannella ML, et al. Insulinoma: A retrospective study analyzing the differences between benign and malignant tumors. Pancreatology. 2018; 18(3): 298–303.
- Kamocki ZK, Wodyńska NA, Pryczynicz A. Co-existence of insulinoma and diabetes: A case report. Oncol Lett. 2014; 8(4): 1697–1700.
- Ghafoori S, Lankarani M. Insulinoma in a patient with type 2 diabetes mellitus. Acta Med Iran. 2015; 53(5): 317–319.
- Assyov Y, Gateva A, Zaharieva E, et al. Concomitant insulinoma and type 2 diabetes mellitus diagnoses: a case report. J Diabetes. 2016; 8(5): 740–742.
- Moller DE, Cohen O, Yamaguchi Y, et al. Prevalence of mutations in the insulin receptor gene in subjects with features of the type A syndrome of insulin resistance. Diabetes. 1994; 43(2): 247–255.
- Burton MC, Warren MB, Lapid MI, et al. Munchausen syndrome by adult proxy: a review of the literature. J Hosp Med. 2015; 10(1): 32–35.
- Trenque T, Hoizey G, Lamiable D. Serious hypoglycemia: Munchausen's syndrome? Diabetes Care. 2001; 24(4): 792–793.
- Ameh V, Speak N. Factitious hypoglycaemia in a nondiabetic patient. Eur J Emerg Med. 2008; 15(1): 59–60.