Insulinomas are rare but are the commonest pancreatic endrocrine neoplasm.
Presentation is usually with symptoms of hypoglycaemia.
Whipples triad suggests insulinoma. It is:
- Neurological symptoms of hypoglycaemia
- Blood glucose levels <50mg/dl and
- Immediate relief of symptoms by ingestion of glucose
10% are multiple, 10% are malignant.
Around 16% are associated with MEN-1.
Diagnosis is by supervised fasting with measurement of glucose, insulin and C-peptide levels.
Treatment is surgical.
If surgery is not an option, medical management options include oral glucose/IV dextrose, glucagon, octreotide and diazoxide.
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