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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