This is a practice problem iam given and I am having trouble isolating what is wrong with this woman, I have a hunch it may have to do with her GLP-1 secretion...but any other suggestions would be helpful
A 45-year-old woman presents with a 7-month history of episodes of dizziness and sweating with difficulty expressing herself, accompanied by disorientation. These episodes resolved quickly when she took dextrose tablets. Home blood glucose monitoring revealed fluctuating concentrations of glucose, between 1 mmol/L and 30 mmol/L (normal 3-6mmol/L). Results of a 75 g oral glucose tolerance test indicated a fasting blood glucose of 8.1 mmol/L, but a 2-h value of 1.9 mmol/L during which the patient started to exhibit the same symptoms of disorientation and sweating. During a 72-h fast she did not develop hypoglycaemia and was completely asymptomatic, although she complained of being very hungry. At the end of the fast, her blood glucose was 7.8 mmol/L. Within 1h of eating she developed symptomatic reactive hypoglycaemia with a plasma glucose of 1.8 mmol/L. Her blood concentrations of plasma insulin increased to 285 mU/L (normal range<3.0 mU/L). A pelvic CT scan showed a 12×11×12 cm encapsulated right-sided pelvic mass which, when sectioned, showed strong immunoreactivity for a neuroendocrine peptide that is normally found in the pancreas and intestines
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