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November 16, 1984

Hyperinsulinemic Hypoglycemia: Differential Diagnosis by Determination of the Species of Circulating Insulin

Author Affiliations

From the Department of Clinical Sciences, Albert Einstein College of Medicine at Montefiore Medical Center (Drs Bauman and Yalow), and the Solomon A. Berson Research Laboratory, Veterans Administration Medical Center (Dr Yalow), Bronx, NY.

JAMA. 1984;252(19):2730-2734. doi:10.1001/jama.1984.03350190032015

Hypoglycemia when associated with hyperinsulinemia is usually a consequence of an insulinoma or the administration of either insulin or an insulin secretagogue. This report describes 14 patients with hypoglycemia whose diagnosis was clarified by the use of a species-specific insulin radioimmunoassay. Eleven of the 14 patients had elevated levels of animal insulin due to surreptitious accidental or malicious administration of insulin. Three of the 14 patients had hyperinsulinemia as the result of excessive human insulin release and were found to have either intrinsic pancreatic disease or secretagogue-mediated insulin release.

(JAMA 1984;252:2730-2734)