Tumor-Induced Hypoglycemia

Hypoglycemia is a common medical emergency. Among hospitalized patients, it is most common in those with diabetes mellitus, but it also occurs in patients with renal insufficiency, liver disease, malnutrition, congestive heart failure, sepsis, or cancer.1,2 Among ambulatory patients, it is most common in patients with diabetes, particularly those treated with insulin. Factitious or surreptitious use of insulin or sulfonylurea drugs is probably the most common cause of hypoglycemia among patients who do not have diabetes. Occasionally, hypoglycemia can be induced by tumors, including pancreatic tumors that secrete insulin3 and non–islet-cell tumors that secrete insulin-like growth factors.4 Strict criteria . . .