CLINICAL RESPONSE OF SPONTANEOUS HYPOGLYCEMIA TO DIETARY AND DRUG THERAPY

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Abstract
It is generally conceded that in spontaneous hypoglycemia of islet cell origin a surgical attack on the pancreas, designed to remove the hyperfunctioning incretory tumor, remains the therapy of choice. However, the need for accurate medical management is of great importance during the preoperative period, and it becomes of paramount importance when prolonged medical therapy is necessitated by the rejection of a definitive operation by the patient or when the surgical risk is believed too great. Moreover, the progressive systemic effects of functioning metastatic islet cells lying beyond the scope of ablative surgery may provoke even a greater challenge to the physician despite an ultimate grave prognosis. Three cases of insulinoma (insulin-secreting islet cell adenoma) are reviewed. Although each patient was ultimately treated by surgery,1experimental observations were made during the preoperative and interim hospital course on the clinical response to dietary, alloxan, corticotropin (ACTH), and cortisone therapy. It

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