• Subhodip Pramanik, Rana Bhattacharjee, Pradip Mukhopadhyay, and Sujoy Ghosh.
• Department of Endocrinology, Institute of Post-Graduate Medical Education and Research, Kolkata, India.
• Clin Med (Lond). 2016 Jun 1; 16 (3): 294296294-6.

AbstractBecause of a pituitary insult and the subsequent loss of counter-regulatory hormones, individuals can experience increased sensitivity to insulin, hypoglycaemia or even complete amelioration of diabetes; this is known as the Houssay phenomenon. Severe dehydration following diarrhoea can lead to pituitary infarction causing hypopituitarism. We describe this situation in a patient with insulin-treated type-2 diabetes presenting with recurrent hypoglycaemia and cessation of insulin requirement along with weight loss, hypotension and hyponatraemia. Pituitary imaging revealed a partial empty sella and a synacthen stimulation test revealed an initial positive response but later loss of response, proving recent-onset pituitary dysfunction. Physicians should keep this possibility in mind while treating hypoglycaemia in stable diabetic individuals. Judicious supplementation of deficient hormones is of utmost importance.© 2016 Royal College of Physicians.

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