Table 2 Differential diagnosis of hyperinsulinemia
From: Insulin autoimmune syndrome induced by exogenous insulin injection: a four-case series
Subject | Insulin resistant syndrome | Type B insulin resistance | Insulinoma | Nesidioblastosis |
|---|---|---|---|---|
Clinical manifestation | hyperandrogenism, widespread acanthosis nigricans, insulin resistance autoimmune disorders | hyperandrogenism, widespread acanthosis nigricans, insulin resistance autoimmune disorders | inappropriately high serum insulin concentrations during an episode of hypoglycemia | inappropriately high serum insulin concentrations and hypoglycemia |
Mechanism | insulin autoantibodies | insulin receptor antibodies | neuroendocrine tumor | excessive function of abnormal pancreatic β-cells |
Treatment | Steroid (Prednisone, 5-10 mg/day) immunosuppressan | insulin and insulin sensitizer steroid and immunosuppressant | complete resection | partial or subtotal pancreatectom. |
Serum insulin levels | generally above 1000 pmol/L | ≥43.05 pmol/L | ↑(moderate) | |