4th April 2024

Insulinoma

This is the most common pancreatic neuroendocrine tumour arising from β cells of the islet of Langerhans. There is an association with MEN-1. High insulin levels lead to hypoglycaemia manifesting as double vision, weakness, confusion and sweating. As insulin is produced in equal amounts as C-peptide the latter is expected to rise in those with insulinomas. Provided Whipple’s criteria is met (hypoglycaemia associated with low blood sugar and resolution of symptoms with glucose administration) then diagnosis is by a supervised 72 hour fast with frequent blood tests and a CT scan of the pancreas. Management consists of surgical excision, however if patients are not surgical candidates, diazoxide and somatostatin can be given.