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Insulinoma

LeeAnne Denny, MD and Scott D. Sholem, DO, MS Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Neoplasm of the pancreatic β cells of the islets of Langerhans leading to hyperinsulinemia. Pancreatic β cells manufacture proinsulin, which is then cleaved into insulin and C-peptid...

DIAGNOSIS

HISTORY

  • Symptoms are typically vague and periodic which can result in a delay in diagnosis of, on average, 18 months (3),(6).

  • Symptoms are often worsened with fasting or exercise but can occur...

TREATMENT

  • Definitive treatment is surgical removal, usually by enucleation (8).

  • Medications can be used to help stabilize blood sugars in patients awaiting surgery, those with metastatic disease, or in...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Watch for recurrence of hypoglycemic symptoms. 

DIET

Frequent high-carbohydrate meals and snacks 

PATIENT EDUCATION

In patients for whom surgery is ...

REFERENCES

1
Patel S, Narwari M, Parekh D, et al. Insulinoma: case report and review of diagnostic and treatment modalities. J Assoc Physicians India.  2013;61(6):423–426. [View Abstract on OvidMe...

SEE ALSO

  • Multiple Endocrine Neoplasia (MEN) Syndromes

  • Algorithm: Hypoglycemia

CODES

ICD10

  • D13.7 Benign neoplasm of endocrine pancreas

  • C25.4 Malignant neoplasm of endocrine pancreas

  • D37.8 Neoplasm of uncertain behavior of oth digestive organs

ICD9

  • 211.7 Benign neoplasm of islets of L...

CLINICAL PEARLS

  • Conduct a C-peptide test if a patient is suspected of self-administering insulin or oral hypoglycemics to mimic symptoms of insulinoma. Proinsulin levels are not elevated with self-adm...

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