18 April 2025
: Case report 
Diagnostic and Surgical Management of Nesidioblastosis in a 42-Year-Old Man with Refractory Hypoglycemia
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Cleomar Ana de Souza Valentim
AEF 1, Vivien Suemi Arimura AEF 2, Isabella De Melo Pompei AEF 2, Denis Bonvechio BDF 3, Marcio Shimabuku Silva BDF 3, Fabio José Turrini BEF 3, Mariana Soares Dalla Mariga Jorgino AEF 4, Andre Silva Valentim ABCDEFG 4*
DOI: 10.12659/AJCR.945453
Am J Case Rep 2025; 26:e945453
Table 2. Assisted fasting protocol for insulinoma investigation.
| ΔT post-hypoglycemia | Glucose (mg/dl) | C-peptide (ng/ml) | Insulin (µIU/ml) | Pro-insulin (pmol/l) | Glycated hemoglobin |
|---|---|---|---|---|---|
| 0 min | 55 | 0.90 | 1.30 | 4.99 | 5.0% |
| 10 min | 79 | – | – | – | – |
| 20 min | 78 | – | – | – | – |
| 30 min | 73 | – | – | – | – |
| Insulin, C-peptide, and pro-insulin levels were collected exclusively at minute 0, where a spontaneous episode of symptomatic hypoglycemia was documented. No instances of symptomatic hypoglycemia were observed at 10, 20, or 30 minutes. | |||||