A 44 year old woman with episodic sweating and hypertension

A 44 year old woman with hypertension and type 2 diabetes (treated with insulin) presented with recurrent 10-15 minute episodes of sweating, tachycardia with regular pulse (110-120 beats/minute), pallor, and occasional increase in blood pressure (from ~130/90 mmHg to ~175/120). These episodes happened two to three times a week over eight months. Glucose readings during these episodes were always greater than 8 mmol/L, ruling out hypoglycaemia. Her medications included doxazosin, metformin, and insulin. She had a body mass index of 32 kg/m2. Physical examination, baseline blood tests, and renal artery doppler were normal. Further investigations were carried out as outlined …