METABOLISM IN ORGANIC HYPERINSULINISM

Abstract

Soon after physicians had come to recognize the characteristic symptoms of insulin hypoglycemia, Harris,¹ in 1924, proposed the concept of endogenous hyperinsulinism. He had noted, in several patients, symptoms similar to those observed after an overdose of insulin and had demonstrated the presence of abnormally low levels of the blood sugar for the duration of such symptoms. He had shown, further, that the symptoms could be relieved promptly by the oral administration of carbohydrate foods. In 1927 Wilder, with others,² in a classic report, presented indisputable evidence that neoplastic pancreatic islet tissue, by producing excessive amounts of substance having the physiologic properties of insulin, caused spontaneous hypoglycemia. It has since been demonstrated repeatedly³ that complete surgical removal of islet cell tumors results almost invariably in disappearance of the hypoglycemic state. Although almost 100 cases have now been reported in which pancreatic islet cell tumors, associated with clinical