20th July 2023

A 45-year-old nurse is brought into resus of the emergency department after being found unresponsive at home by her partner

A 45-year-old nurse is brought into resus of the emergency department after being found unresponsive at home by her partner. Following thorough assessment, she is found to have a blood glucose level of 1.2 mmol/L. She is given intravenous dextrose 20%, following which she slowly regains consciousness. She is admitted for monitoring. A collateral history reveals that she has been having recurrent episodes of dizziness, confusion and sweating profusely over the last year. These usually occur in the morning or after busy days at work. She has no past medical history, takes no regular medications and there is no relevant family history. All examinations are unremarkable. During her admission, her blood sugar fluctuates with hypoglycaemic episodes every morning. The endocrinology team suspect an insulinoma.

What is the first line investigation to confirm this condition?

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