Case Report: Diazoxide-induced diabetic ketoacidosis in a patient with insulinoma

Definitive management of insulinoma is challenging as curative surgery is associated with a considerable risk of morbidity and mortality. The successful long-term use of diazoxide for patients diagnosed with insulinoma has been described, but rarely, the use of diazoxide can be complicated by diabet...

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Main Authors: Run Ting Chin, Jolene Jiayu Kiew, Khek Yu Ho, Doddabele S. Deepak
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1524288/full
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author Run Ting Chin
Jolene Jiayu Kiew
Khek Yu Ho
Doddabele S. Deepak
author_facet Run Ting Chin
Jolene Jiayu Kiew
Khek Yu Ho
Doddabele S. Deepak
author_sort Run Ting Chin
collection DOAJ
description Definitive management of insulinoma is challenging as curative surgery is associated with a considerable risk of morbidity and mortality. The successful long-term use of diazoxide for patients diagnosed with insulinoma has been described, but rarely, the use of diazoxide can be complicated by diabetic ketoacidosis (DKA). This case report describes a frail elderly patient with high surgical risk diagnosed with pancreatic head insulinoma whose initial treatment with diazoxide was complicated by a hyperglycemic crisis. Her insulinoma was eventually managed with endoscopic ultrasound-guided-radiofrequency ablation (EUS-RFA) with complete resolution of hypoglycemic episodes. This case highlights the importance of monitoring for side effects of diazoxide, especially in the elderly, and the role of EUS-RFA as an emerging non-surgical treatment modality for insulinoma.
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issn 1664-2392
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publishDate 2025-05-01
publisher Frontiers Media S.A.
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series Frontiers in Endocrinology
spelling doaj-art-0a33a1d2ac064718a4f9b828c681e35d2025-08-20T03:51:58ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-05-011610.3389/fendo.2025.15242881524288Case Report: Diazoxide-induced diabetic ketoacidosis in a patient with insulinomaRun Ting Chin0Jolene Jiayu Kiew1Khek Yu Ho2Doddabele S. Deepak3Division of Endocrinology, Department of Medicine, National University Hospital, National University Health Systems, Singapore, SingaporeDivision of Endocrinology, Department of Medicine, Ng Teng Fong General Hospital, National University Health Systems, Singapore, SingaporeDivision of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, National University Health Systems, Singapore, SingaporeDivision of Endocrinology, Department of Medicine, National University Hospital, National University Health Systems, Singapore, SingaporeDefinitive management of insulinoma is challenging as curative surgery is associated with a considerable risk of morbidity and mortality. The successful long-term use of diazoxide for patients diagnosed with insulinoma has been described, but rarely, the use of diazoxide can be complicated by diabetic ketoacidosis (DKA). This case report describes a frail elderly patient with high surgical risk diagnosed with pancreatic head insulinoma whose initial treatment with diazoxide was complicated by a hyperglycemic crisis. Her insulinoma was eventually managed with endoscopic ultrasound-guided-radiofrequency ablation (EUS-RFA) with complete resolution of hypoglycemic episodes. This case highlights the importance of monitoring for side effects of diazoxide, especially in the elderly, and the role of EUS-RFA as an emerging non-surgical treatment modality for insulinoma.https://www.frontiersin.org/articles/10.3389/fendo.2025.1524288/fullinsulinomadiazoxidediabetic ketoacidosisendoscopic ultrasoundradiofrequency ablation
spellingShingle Run Ting Chin
Jolene Jiayu Kiew
Khek Yu Ho
Doddabele S. Deepak
Case Report: Diazoxide-induced diabetic ketoacidosis in a patient with insulinoma
Frontiers in Endocrinology
insulinoma
diazoxide
diabetic ketoacidosis
endoscopic ultrasound
radiofrequency ablation
title Case Report: Diazoxide-induced diabetic ketoacidosis in a patient with insulinoma
title_full Case Report: Diazoxide-induced diabetic ketoacidosis in a patient with insulinoma
title_fullStr Case Report: Diazoxide-induced diabetic ketoacidosis in a patient with insulinoma
title_full_unstemmed Case Report: Diazoxide-induced diabetic ketoacidosis in a patient with insulinoma
title_short Case Report: Diazoxide-induced diabetic ketoacidosis in a patient with insulinoma
title_sort case report diazoxide induced diabetic ketoacidosis in a patient with insulinoma
topic insulinoma
diazoxide
diabetic ketoacidosis
endoscopic ultrasound
radiofrequency ablation
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1524288/full
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