A 74-year-old woman presented with one month of palpitation and sweating. She was otherwise healthy and was not taking any previous medications. Her symptoms first appeared two years ago and mostly occurred four hours after lunch. She had reported to a local hospital; however, neither her plasma glucose nor other lab parameters suggested hypoglycemia at that time. Interestingly, after one month, the symptoms had resolved spontaneously, and no CPG or fasting plasma glucose could be recorded.
Simple carbohydrates in the form of fruit juices or syrup were prescribed to her to prevent hypoglycemia, which further led to a 10 kg weight gain. Her symptoms had been absent for the last two years until her current presentation. For the last one month symptoms appeared every day 3 hours after lunch and resolved after the afternoon snack. She denied using any hypoglycemic agents. She had no fever,…
