{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T21:32:52Z","timestamp":1793827972638,"version":"4.6.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T00:00:00Z","timestamp":1707436800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T00:00:00Z","timestamp":1707436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Health Committee of Hunan Province","award":["20201755"],"award-info":[{"award-number":["20201755"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Endocrine"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Context<\/jats:title>\n                <jats:p>Insulinoma is a neuroendocrine tumor derived from pancreatic \u03b2 -cells whose clinical manifestation is recurrent hypoglycemia. Insulinoma in a patient with preexisting diabetes is extraordinarily rare, and the unmasking of type 2 diabetes (T<jats:sub>2<\/jats:sub>DM) after insulinoma surgery is even rarer.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case report<\/jats:title>\n                <jats:p>This article reports a 49-year-old male patient with insulinoma that masked the diagnosis of T<jats:sub>2<\/jats:sub>DM. The patient was admitted to the hospital with symptoms of hypoglycemia, such as repeated sweating, palpitations, and asthenia for over 4 years. The patient was diagnosed with insulinoma after completing relevant examinations. The emergence of hyperglycemia after the removal of insulinoma is attributable to the coexistence of T<jats:sub>2<\/jats:sub>DM. Surprisingly, a reversible decrease in cortisol levels was observed during the diagnostic process. We searched the previously published reports of this type of case from PubMed to determine why type 2 diabetes was covered by insulinoma and why glucocorticoids decreased.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The diagnosis of T<jats:sub>2<\/jats:sub>DM in the patient after surgery may be related to increased food intake and insulin resistance induced by hyperinsulinemia caused by long-term hypoglycemia. The reversible decrease in cortisol levels, not adrenocortical insufficiency during the diagnostic process, may be caused by a transient abnormality in glucose counterregulation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s12020-024-03703-9","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T13:02:20Z","timestamp":1707483740000},"page":"885-889","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A rare case report of reversible glucose counterregulation in an insulinoma patient with type 2 diabetes"],"prefix":"10.1007","volume":"84","author":[{"given":"Jian-hui","family":"Teng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-pei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4795-0141","authenticated-orcid":false,"given":"Jing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,9]]},"reference":[{"issue":"1","key":"3703_CR1","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s40618-016-0536-3","volume":"40","author":"MV Davi","year":"2017","unstructured":"M.V. Davi et al. The treatment of hyperinsulinemic hypoglycaemia in adults: an update. J. Endocrinol. Invest 40(1), 9\u201320 (2017)","journal-title":"J. Endocrinol. Invest"},{"issue":"17","key":"3703_CR2","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1056\/NEJM199504273321707","volume":"332","author":"FJ Service","year":"1995","unstructured":"F.J. Service, Hypoglycemic disorders. N. Engl. J. Med 332(17), 1144\u201352 (1995)","journal-title":"N. Engl. J. Med"},{"issue":"7","key":"3703_CR3","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/S0025-6196(12)62083-7","volume":"66","author":"FJ Service","year":"1991","unstructured":"F.J. Service et al. Functioning insulinoma\u2013incidence, recurrence, and long-term survival of patients: a 60-year study. Mayo Clin. Proc. 66(7), 711\u20139 (1991)","journal-title":"Mayo Clin. 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Rohl, Case report: hypoglycemia due to metastatic insulinoma in insulin-dependent type 2 diabetes successfully treated with 177 Lu-DOTATATE. Front Endocrinol. (Lausanne) 13, 906012 (2022)","journal-title":"Front Endocrinol. (Lausanne)"},{"issue":"Suppl 2","key":"3703_CR7","doi-asserted-by":"publisher","first-page":"S262","DOI":"10.2337\/dc08-s264","volume":"31","author":"MH Shanik","year":"2008","unstructured":"M.H. Shanik et al. Insulin resistance and hyperinsulinemia: is hyperinsulinemia the cart or the horse?. Diabetes Care 31(Suppl 2), S262\u20138 (2008)","journal-title":"Diabetes Care"},{"key":"3703_CR8","doi-asserted-by":"publisher","first-page":"111315","DOI":"10.1016\/j.biopha.2021.111315","volume":"137","author":"B Ahmed","year":"2021","unstructured":"B. Ahmed, R. Sultana, M.W. Greene, Adipose tissue and insulin resistance in obese. Biomed. Pharmacother. 137, 111315 (2021)","journal-title":"Biomed. 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