Abstract
HYPERGLYCEMIA occurs commonly after removal of an islet cell tumor, but the cause is not fully understood. It has been suggested that long-standing hyperinsulinemia and hypoglycemia may have led to a decline of βcell activity in the remainder of the pancreas.<sup>1,2</sup>In support of this view is the finding of decreased insulin content in pancreatic tissue adjacent to the adenoma.<sup>3,4</sup>It also has been suggested that antagonism to insulin action may have developed, and that after surgery the antagonism requires time to dissipate.<sup>5</sup>The finding of increased plasma insulin following removal of the adenoma is given as evidence for this view.<sup>4,5</sup>These latter observations were of short duration, however, and it is possible that insulin produced by the adenoma may still have been in circulation. Therefore, the present patient is reported because high levels of plasma immunoreactive insulin (IRI) after glucose challenge were found 15 weeks following resection of an
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