A 45 years old man, chronic alcoholic developed acute pancreatitis after resolving he became diabetic. Initially he was advised insulin and later switched over to oral antidiabetics.He had several incidents of severe hypoglycemic episodes (glucose less than 50 mg %)resulting in unconsciousness,injuries and hospitalization. One complaint he made is of experiencing hypoglycemic symptoms immediately after taking meal which recovered after one to two hours.He was on combination of Metformin,voglibose and pioglitazone. His dosage were gradually reduced and seeing no cure of hypoglycemia medications were completely with drawn.
Lab tests reports showed:- FBG 82 mgs/dl , Hba1c 6.1 % F insulin 12. 10 Micro unit/ ml., C-peptide 0.3 ng/ ml. LET, KFT, thyroid profile, lipid profile in normal range. Kindly share diagnosis and management of this case.
