2017 Volume 60 Issue 1 Pages 18-24
A 67-year-old man with type 1 diabetes had no residual endogenous insulin secretion and had been treated with basal-bolus insulin therapy. He was diagnosed with adrenaline-producing pheochromocytoma and underwent laparoscopic left adrenalectomy. His glycemic variability for 24 h was evaluated using continuous glucose monitoring (CGM) before and 7 days after the operation. The mean glucose level was 177.1 mg/dL, the M value was 36.6, MAGE was 167 mg/dL, and J-index was 55.8 on preoperative CGM. Seven days after the operation, the mean glucose level had decreased to 131.5 mg/dL with an M value of 22.9, MAGE of 116 mg/dL, and J-index of 37.0, indicating that the glycemic variability had decreased markedly after surgery. In addition, the total daily insulin dose was immediately decreased from 21 to 16 units by excision of the pheochromocytoma. This clinical course suggested that a decrease in excessive catecholamine resulted in the improvement of the glucose levels through the improvement of insulin resistance in a patient with type 1 diabetes.
