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insulinomarelated

Insulinoma-related refers to the clinical and management aspects of insulinomas, rare pancreatic neuroendocrine tumors that secrete insulin and cause recurrent hypoglycemia. The excess insulin leads to neuroglycopenic and autonomic symptoms, particularly during fasting or exertion.

Most insulinomas are sporadic and benign, though a minority are malignant or part of multiple endocrine neoplasia

Clinical features commonly include symptoms of hypoglycemia such as shakiness, sweating, palpitations, confusion, weakness, or visual

Diagnosis relies on biochemical and imaging studies. Biochemically, during a hypoglycemic episode, insulin, C-peptide, and proinsulin

Management centers on tumor removal when feasible. Surgical enucleation is often curative for small, benign insulinomas;

type
1
(MEN1).
The
annual
incidence
is
roughly
1–4
per
million
people.
Up
to
about
10%
occur
in
the
context
of
MEN1,
which
may
involve
other
endocrine
tumors.
disturbance.
These
episodes
often
improve
after
glucose
intake.
Whipple’s
triad—documented
hypoglycemia,
symptoms
with
hypoglycemia,
and
relief
with
glucose—helps
raise
suspicion.
are
inappropriately
elevated.
A
supervised
72-hour
fast
or
a
sustained
hypoglycemia
episode
with
appropriate
lab
findings
confirms
the
diagnosis.
Localizing
the
tumor
uses
imaging
such
as
contrast-enhanced
CT
or
MRI,
endoscopic
ultrasound,
and
functional
imaging
with
somatostatin-receptor
imaging
(for
example,
Ga-68
DOTATATE
PET).
Differential
includes
factitious
hypoglycemia
from
exogenous
insulin
or
sulfonylureas.
larger
or
multiple
tumors
may
require
distal
pancreatectomy
or
more
extensive
resection.
In
MEN1
or
unresectable/metastatic
disease,
medical
therapies
such
as
diazoxide
(to
inhibit
insulin
release),
somatostatin
analogs
(e.g.,
octreotide),
everolimus,
and
peptide
receptor
radionuclide
therapy
can
help
control
hypoglycemia
and
tumor
growth.
Dietary
measures
with
frequent
small
meals
support
control.
Prognosis
is
generally
favorable
after
complete
resection,
though
recurrence
can
occur,
especially
in
MEN1-associated
cases.