Endocrine Abstracts

JOINT1156

Background and aim: Continuous glucose monitoring (CGM) is an essential part of diabetes management. It allows to assess blood glucose level in real time and avoid hyper- and hypoglycemia. But in this case report we describe a patient without diabetes but frequent hypoglycemic events. With the help of CGM he was diagnosed with insulinoma and treated properly.Сlіnісal сaseA 59-year man presented with palpitation, dizziness, tremor, and general weakness that occur during fasting. Hіstоrу revealed that he experienced these symptoms nearly 6 months. Preliminary diagnosis was hypoglycemic syndrome. At outpatient’s clinic fasting glycemia was in reference range. Laboratory tests demonstrated: fasting glycemia 5.1 mmol/l; HbA1c level 5.2%; C-peptide test 4.9 ng/ml (1.1-4.4); insulin level 27 mIU/mL (3-25); plasma cortisol and plasma ACTH levels were in reference ranges. Family history is negative for diabetes. Оn examіnatіоn: dry skin, BMI 25,9 kg/m². Patient did not take any pharmacological agents, including sulfonylurea and insulin. He was proposed to use CGM to find out a cause of his symptoms. CGM report revealed that he experienced unexplained hypoglycemic states at night and early morning. After detailed questioning patient reported that at those exact times he felt hunger, was sweaty, and agitated. Our next step was to perform CT-scan of abdomen to look for a tumor. CT-scan revealed a 2 cm tumor in the head of pancreas. After successful surgery we still follow-up the patient.СоnсlusіоnOur clinical case describes an unconventional use of CGM. It can be used not only to manage diabetic patients, but also to monitor glucose levels in all patients with disordered glucose metabolism.