April 21, 2000
Diagnosis and Symptoms
Question from Raven, Virginia, USA:
My husband is 36 years old. His grandmother has high blood sugar, but to our knowledge no one else in his family has problems with their sugar (high or low). Recently he went for a pre-employment physical and the only thing the employer told him that showed up from his physical was an enlarged pancreas, high cholesterol (260) and low blood sugar (52). During the physical, blood work was done and an abdominal ultrasound. Could his enlarged pancreas have anything to do with his low sugar? Approximately 2 years ago, after a bout with the flu, his sugar was tested along with other blood work and his count came back as 42. During the last 15 or so years, he has had problems occasionally (about every month or two) with stomach pain, diarrhea after eating fatty foods and night sweats. Can you help us with some information or suggestions about a follow-up doctor visit?
Answer:
From the few things you report, it seemed to me that the most likely cause might be some form of chronic pancreatitis that was causing your husband to have an enlarged pancreas and the occasional gastrointestinal symptoms. This may be due to alcohol use or other reasons (but I have not been told about this); but as part of the pancreatitis there may have been some damage to islet cells, perhaps enough to cause some delay in first phase insulin release. But the low blood sugars might also be due to either liver (such as chronic hepatitis) or alpha cell involvement.
I suppose I would want insulin and glucagon challenge tests and ultimately a biopsy to help make a diagnosis.
MS