{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T02:26:24Z","timestamp":1778034384116,"version":"3.51.4"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Insulinomas are rare, typically benign pancreatic neuroendocrine tumors that cause endogenous hyperinsulinemic hypoglycemia. While usually diagnosed in middle age, their presence in young adults may suggest hereditary syndromes, such as MEN1. While semaglutide and other GLP-1 receptor agonists rarely cause hypoglycemia, they can unmask tumors secreting insulin<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 25-year-old woman with obesity and polycystic ovary syndrome (PCOS) developed severe hypoglycemia (35\u00a0mg\/dL) after starting semaglutide. She did not respond to IV dextrose. Labs showed hyperinsulinemia (77.5\u00a0mU\/L) and elevated C-peptide (19.53\u00a0ng\/mL). Imaging revealed a pancreatic tail mass, pituitary microadenoma, and ovarian teratoma, raising concern for MEN1. She underwent distal pancreatectomy, splenectomy, and right salpingo-oophorectomy. Glycemia normalized postoperatively. Pathology confirmed a grade 1 pancreatic neuroendocrine tumor (Ki-67\u2009&amp;lt;\u20091%)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case emphasizes that hypoglycemia occurring during GLP-1 receptor agonist therapy is not always a drug-related side effect but may result from unmasking of an underlying insulinoma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/omcr\/omaf283","type":"journal-article","created":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T12:57:50Z","timestamp":1764421070000},"source":"Crossref","is-referenced-by-count":1,"title":["Unmasking an insulinoma: recurrent Hypoglycemia in a young patient following GLP-1 receptor agonist therapy \u2014A case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2553-8434","authenticated-orcid":false,"given":"Nicole","family":"Baldera-Rodriguez","sequence":"first","affiliation":[{"name":"Knowledge Management and Epidemiology Department, CEDIMAT , Plaza de la Salud, Dr. Juan Manuel Taveras Rodr\u00cdguez, C. Pepillo Salcedo esq. Arturo Logro\u00f1o, Ensanche La Fe, Santo Domingo 10107 ,","place":["Dominican Republic"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Simo-Campillo","sequence":"additional","affiliation":[{"name":"Knowledge Management and Epidemiology Department, CEDIMAT , Plaza de la Salud, Dr. Juan Manuel Taveras Rodr\u00cdguez, C. Pepillo Salcedo esq. Arturo Logro\u00f1o, Ensanche La Fe, Santo Domingo 10107 ,","place":["Dominican Republic"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0039-7311","authenticated-orcid":false,"given":"Patricia","family":"Sanrregre-Oven","sequence":"additional","affiliation":[{"name":"Knowledge Management and Epidemiology Department, CEDIMAT , Plaza de la Salud, Dr. Juan Manuel Taveras Rodr\u00cdguez, C. Pepillo Salcedo esq. Arturo Logro\u00f1o, Ensanche La Fe, Santo Domingo 10107 ,","place":["Dominican Republic"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrique Capellan","family":"Lopez","sequence":"additional","affiliation":[{"name":"Knowledge Management and Epidemiology Department, CEDIMAT , Plaza de la Salud, Dr. Juan Manuel Taveras Rodr\u00cdguez, C. Pepillo Salcedo esq. Arturo Logro\u00f1o, Ensanche La Fe, Santo Domingo 10107 ,","place":["Dominican Republic"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3659-6665","authenticated-orcid":false,"given":"Ramon","family":"Romano","sequence":"additional","affiliation":[{"name":"Knowledge Management and Epidemiology Department, CEDIMAT , Plaza de la Salud, Dr. Juan Manuel Taveras Rodr\u00cdguez, C. Pepillo Salcedo esq. Arturo Logro\u00f1o, Ensanche La Fe, Santo Domingo 10107 ,","place":["Dominican Republic"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4747-3089","authenticated-orcid":false,"given":"Anahi B","family":"Goicochea","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, CEDIMAT , Plaza de la Salud, Dr. Juan Manuel Taveras Rodr\u00cdguez, C. Pepillo Salcedo esq. Arturo Logro\u00f1o, Ensanche La Fe, Santo Domingo 10107 ,","place":["Dominican Republic"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,25]]},"reference":[{"key":"2026012509584098800_ref1","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1210\/clinem\/dgad641","article-title":"Approach to the patient: insulinoma","volume":"109","author":"Hofland","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"2026012509584098800_ref2","volume-title":"Medscape [Internet]","author":"Vinik"},{"key":"2026012509584098800_ref3","volume-title":"StatPearls [Internet]","author":"","year":"2025"},{"key":"2026012509584098800_ref4","volume-title":"Endotext [Internet]"},{"key":"2026012509584098800_ref5","doi-asserted-by":"publisher","first-page":"339","DOI":"10.3389\/fendo.2019.00339","article-title":"Multiple endocrine neoplasia type 1 (MEN1): an update and the significance of early genetic and clinical diagnosis","volume":"10","author":"Kamilaris","year":"2019","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026012509584098800_ref6","volume-title":"UpToDate [Internet]","author":""},{"key":"2026012509584098800_ref7","doi-asserted-by":"publisher","first-page":"32","DOI":"10.2337\/diaclin.32.1.32","article-title":"Optimizing the care of patients with type 2 diabetes using incretin-based therapies: a focus on GLP-1 receptor agonists","volume":"32","author":"","year":"2014","journal-title":"Clin Diabetes"},{"key":"2026012509584098800_ref8","doi-asserted-by":"publisher","first-page":"e177","DOI":"10.2337\/dc14-0514","article-title":"GLP-1 provoked severe hypoglycemia in an individual with type\u00a02 diabetes and a benign insulinoma","volume":"37","author":"Ruby","year":"2014","journal-title":"Diabetes Care"},{"key":"2026012509584098800_ref9","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1186\/s13023-022-02370-1","article-title":"Analysis of 55 patients with multiple endocrine neoplasia type 1-associated insulinoma from a single center in China","volume":"17","author":"Zhao","year":"2022","journal-title":"Orphanet J Rare Dis"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/1\/omaf283\/66569232\/omaf283.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/omcr\/article-pdf\/2026\/1\/omaf283\/66569232\/omaf283.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T14:58:51Z","timestamp":1769353131000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omaf283\/8440725"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,24]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omaf283","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2026,1]]},"article-number":"omaf283"}}