Insulinoma Unmasked By Tirzepatide: A Rare Case of Postprandial Hypoglycemia In a Nondiabetic Patient.
Polisky. Michael M; Kamel. Dina D; Ku. Jeong-Hee JH
Key Findings
- Tirzepatide can exacerbate post‑prandial hypoglycemia in patients with an undiagnosed insulinoma.
- Severe hypoglycemia after starting tirzepatide should prompt evaluation for insulinoma, even in non‑diabetic individuals.
- Incretin‑based therapies may unmask underlying endocrine disorders that were previously asymptomatic.
Practical Outcomes
- If you’re using tirzepatide for weight loss and notice unexpected low blood sugar after meals, consider getting checked for an insulinoma. Monitoring blood glucose closely during the first weeks of therapy can catch rare but serious reactions early. This case doesn’t change dosing guidelines but adds a safety checkpoint for rare conditions.
Summary
A 63‑year‑old woman with obesity started tirzepatide for weight loss and then experienced severe low blood sugar after meals. Doctors discovered she actually had an insulin‑producing tumor (insulinoma), which the drug made the hypoglycemia worse. The report shows that tirzepatide can reveal hidden insulinomas and cause dangerous drops in blood sugar.
Abstract
A 63-year-old woman with obesity presented with severe postprandial hypoglycemia that worsened after starting tirzepatide for weight loss. Further evaluation led to the diagnosis of insulinoma. This case suggests that the use of tirzepatide can provoke severe hypoglycemia episodes in patients with insulinoma and highlights the importance of including insulinoma as a differential diagnosis for hypoglycemia in patients taking incretin-based therapy.
Study Information
pubmed
2025
2025-12-04T00:00:00.000Z
10.1210/jcemcr/luaf290
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