ArticleAACE clinical case reports
PROINSULIN-PREDOMINANT PANCREATIC NEUROENDOCRINE TUMOR-INDUCED HYPOGLYCEMIA AFTER ROUX-EN-Y GASTRIC BYPASS SURGERY.
Article in AACE clinical case reports. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Metastatic proinsulin-secreting tumor: a rare cause of persistent hypoglycemia.JCEM case reports · 2026Article
- Insulinoma after Roux-en-Y gastric bypass successfully treated by endoscopic ultrasound-guided radiofrequency ablation.JCEM case reports · 2026Article
- Personalized Diabetes Therapy Part 1-Functional Phenotyping as a Conceptual Basis for Individualized Treatment.Journal of personalized medicine · 2026Review
- Intraoperative selective arterial calcium injection test to confirm complete resection of a proinsulinoma.Journal of surgical case reports · 2022Article
- Metastatic insulinoma presenting after bariatric surgery in a patient diagnosed with MEN1.Clinical case reports · 2022Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo present a case of recurrent hypoglycemia following Roux-en-Y gastric bypass (RYGB) surgery whose etiology was determined to be a proinsulin-predominant pancreatic neuroendocrine tumor (a proinsulinoma).
methodsA case report along with a brief discussion and review of the pertinent literature is presented.
resultsThe patient is a 62-year-old female who presented with symptomatic hypoglycemia 11 years after RYGB surgery. Initial workup revealed low insulin levels with elevated proinsulin levels. A 72-hour fast confirmed the presence of proinsulin-induced hypoglycemia secondary to a pancreatic neuroendocrine tumor (PNET). She underwent distal pancreatectomy with splenectomy and a PNET tumor was successfully removed with resolution of her symptoms.
conclusionHypoglycemia after RYGB surgery is a well-established syndrome. While there are several etiologies for this, PNETs (including proinsulinomas) should be considered in the differential diagnosis in this population. Proinsulinomas are an increasingly recognized cause of hypoglycemia. Proinsulin levels must always be included as part of the workup of hypoglycemia in an adult.
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Registered trials
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