A patient presents with increased insulin, increased c-peptide, and decreased serum glucose after relief from hypoglycemia. What diagnosis is suggested?

The scenario describes a patient who experiences increased insulin levels and C-peptide levels, along with decreased serum glucose after relief from hypoglycemia. This combination of findings is most consistent with an insulinoma, which is a tumor of the pancreatic beta cells that secretes insulin autonomously.

In insulinoma, patients typically present with episodes of hypoglycemia due to excess insulin production, leading to increased insulin levels in the bloodstream. The presence of C-peptide is significant because it indicates that the insulin being produced is from endogenous sources. In patients with exogenous insulin injection (like in some cases of malingering hypoglycemia), C-peptide levels would be low since suppling insulin from outside the body would not trigger the pancreas to produce more insulin.

The key detail in this case is the relief from hypoglycemic symptoms along with the noted increase of both insulin and C-peptide levels. This strongly suggests an endogenous source of insulin.

In contrast, if the patient had diabetes mellitus, typically one would expect either normal or low C-peptide levels if they were on exogenous insulin therapy, making it a less likely diagnosis in this scenario.

Pancreatic endocrine neoplasms as a broader category could include insulinomas, but the specific