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Roger L. Nelson, MD; Robert A. Rizza, MD; F. John Service, MD

JAMA. 1978;240(17):1891.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

IT IS well known that the diagnosis of insulinoma may be delayed because of the variable presentation of symptomatic hypoglycemia. Hypoglycemic symptoms were present for more than three years in 38% of 154 patients seen at the Mayo Clinic from 1927 to 1964¹ and in 15 of 60 patients seen there from 1964 to 1975.² Twenty-five percent of 258 patients reported in the world literature up to 1949³ had symptoms for more than five years before operative intervention. Documentation of hypoglycemia generally follows the onset of symptoms by some time. The longest period of documented hypoglycemia that we could locate in the literature was 15 years.³

We recently noted hyperinsulinemia in a patient who has had symptoms compatible with fasting hypoglycemia for more than 50 years and in whom hypoglycemia had been demonstrated 23 years previously.

Report of a Case

A 74-year-old woman was seen at the . . . [Full Text PDF of this Article]

Author Affiliations
From the Mayo Clinic and Mayo Foundation, Rochester, Minn.

Footnotes
Reprint requests to Mayo Clinic, 200 First St SW, Rochester, MN 55901 (Dr Nelson).

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