Endocrine Abstracts

Insulinoma is the most common cause of hypoglycemia related to endogenous hyperinsulinism in adults. It is very rare in pregnancy, fewer than 30 cases of insulinoma presenting in pregnancy have been reported so far and it’s managment is very challenging. We raported here the case of a pregnant women aged 35 years presenting an insulinoma.

The diagnosis was made 1 year ago in the presence of hypoglycemia, high levels of inulin and C-peptide and a 10 mm tumor in the body of the pancreas detected with endoscopic ultrasound. The patient was operated on but the surgery failed and hypoglycemia recurred few months later with the same biological and radiological findings as preoperatively. While the patient was waiting for reoperation a pregnancy occured with worsening of the hypoglycemic episodes in the first trimester as reported due to the increase in insulin sensitivity during early pregnancy, the patient was successfully managed with frequent feedings hoping that hypoglycemia will improve during the second and third trimester with the rise of isulin resistance, thereafter the patient will be operated after delivery.