Insulinoma Unmasked By Tirzepatide: A Rare Case of Postprandial Hypoglycemia In a Nondiabetic Patient.

JCEM case reports2026PMID: 41356535

View on PubMed DOI: 10.1210/jcemcr/luaf290

Plain Language Summary

Case report of a 63-year-old non-diabetic woman with obesity who developed severe postprandial hypoglycemia after starting tirzepatide, ultimately diagnosed with insulinoma. Tirzepatide's augmentation of glucose-stimulated insulin secretion unmasked a clinically occult insulinoma. Provides another case demonstrating that tirzepatide—like semaglutide—can unmask occult insulinomas through insulin secretion augmentation—reinforcing the clinical principle that unexplained hypoglycemia following incretin therapy initiation in a non-diabetic patient requires insulinoma investigation.

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.

Authors

Polisky, Michael; Kamel, Dina; Ku, Jeong-Hee

Keywords

GIP receptor agonistGLP-1 receptor agonistinsulinomaneuroendocrine tumorpostprandial hypoglycemiatirzepatide