The miracle of insulin
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Renal cell carcinoma has previously been associated with hypoglycaemia in the setting of non-islet cell tumours, caused by a paraneoplastic phenomenon relating to the production of insulin-like growth factor type II. We present a case of recurrent clear cell renal cell carcinoma, leading to an insulin-mediated paraneoplastic phenomenon causing severe recurrent hypoglycaemia. Hypoglycaemina was managed successfully using diazoxide therapy, in conjunction with pazopanib and radiotherapy to reduce tumour burden.
Controlling blood glucose in type 2 diabetes remains challenging. All existing drugs have significant limitations and side effects, with some causing weight gain and thereby exacerbating the condition. This short review looks at new groups of drugs on the market and under development, and discusses their potential in the management of type 2 diabetes.
Keywords DPP-IV inhibitors, hypoglycaemia, incretin mimetics, obesity, thiazolidinediones, type 2 diabetes, weight loss drugs