You are scheduled to see a 64-year-old woman for the first time in your office. She recently moved to your town from another state. You received her medical records from her previous health care provider. As you reviewed her recent medical records, you noticed her most recent glucagon level is 20 times the normal level. A CT scan of her abdomen demonstrated a mass in the tail of the pancreas. Which of the following symptoms establish the diagnosis in this patient?
