Insulinomas do not often bring up noticeable symptoms and even when symptoms occur, they vary depending on the severity. More severe symptoms can affect the brain, as well as adrenal glands, which regulate stress response and heart rate.
Signs may include:
- Weakness and fatigue
- Excessive and profuse sweating
- Frequent hunger
- Back and abdominal pains
- Blurry vision
- Seizures and convulsions
- Rapid heart rate
- Mood changes and swings such as anxiety, depression, fear, etc.
- Non-concentration and confusion
- Loss of consciousness/coma.
The exact cause of insulinoma is not known. The tumor typically shows up without warning. However, some factors have been associated with its development.
Such risk factors include:
- Multiple endocrine neoplasia type 1, which is an abnormal tissue growth in the endocrine system
- Von Hippel-Lindau syndrome; a genetic disease that causes the growth of tumors and cyst all through the body.
- Other generic diseases such as neurofibromatosis type 1, tuberous sclerosis, et
More about Treatment
An insulinoma is a tumor of the pancreas that is derived from beta cells and secretes insulin. Insulinoma develops in the neuroendocrine cells of the pancreas and spread to the other parts of the body. Insulinoma is a pancreatic neuroendocrine tumor with uncertain causes but several risk factors. The symptoms/signs are hardly noticeable and can vary according to severity. Diagnosis is often done through blood tests and there are several treatment options.
The pancreas functions by making insulin, which helps keep the body's blood sugar level balanced. Insulin tumors also make extra insulin more than the body can use.
Normally, the pancreas stops producing insulin when it notices a low blood sugar level, to allow the blood sugar level to return to normal. But when insulinomas are formed in the pancreas, the tumor continues to produce insulin even when the blood sugar is low, this hindering the blood sugar regulation function of the pancreas cells. This condition, therefore, leads to low blood sugar–hypoglycemia.
Insulinoma is a rare form of neuroendocrine tumor. Contrary to characteristics of the tumor, which are mostly malignant, most insulinomas are benign in that they grow exclusively at their origin within the pancreas, but the minority is metastasized.
To diagnose insulinomas, your doctor goes through your medical history to check for risk factors and underlying conditions that can cause the development of the tumor.
Tests to perform may include:
- Blood tests through a suppression test
The suppression test is done after a 72-hour fast to see if insulin fails to suppress. If it fails to suppress, it is an indication that there is a presence of an insulin-secreting tumor.
When this is determined, blood is drawn to test for:
- Serum glucose
- C-peptide levels
- Imagery Tests such as:
- Endoscopic ultrasound; to detect tumors in the pancreas–insulinomas.
- CT scans, MRI, and X-rays to view the inside of the pancreas for abnormal growths.
Most insulinomas are not cancerous. However, treatments can include the following:
The most preferred treatment for insulinoma is surgery. The position of the tumor is known using diagnostic testing or surgical examination. Insulinomas can be removed through endoscopic, laparoscopic, and other surgical procedures.
- Octreotide Injections, to reduce the production of insulin and glucagon.
- Radiofrequency Ablation, a non-surgical, minimally invasive procedure that uses high-frequency radiation to reduce or stop the transmission of pain signals to the brain.
- Embolization Process, a minimally invasive treatment that blocks blood vessels to prevent blood flow to the tumor.
Complications that may occur as a result of the pancreatic tumor/insulinoma include:
- Intestinal obstruction.
- Permanent diabetes mellitus.
- Spread of cancer cells.
Complications that can arise as a result of its treatments include:
- Pancreatic fistula, which is the damage or wound in the pancreas. This can result from the removal of the pancreatic tumor.
- Pseudocyst; a false (usually damaged) cyst that may appear as a cyst on scans but does not have any endothelial or epithelial cells.
- Pancreatic leakage of fluids.
- Abscess; pus collection in body tissues.
- Pancreatitis; pancreas inflammation.
A mortality rate of 7.7% has been reported for insulinomas, with a median survival time of 12.7 years.
- How rare is an insulinoma?
Insulinoma is the most common neuroendocrine tumor of the pancreatic system. It can be seen in every age but is mostly seen in people above 50 years and is more common in women than in men. Abut 90% of insulinomas are benign (not cancerous) and solitary, and only 10% are malignant (cancerous)
- How do you rule out an insulinoma?
The diagnosis of insulinoma is usually made biochemically with low blood glucose, elevated insulin, insulin, and C-peptide levels. It is confirmed by localizing the tumor with medical imagery tests or angiography.
The following blood test can be done for diagnosis:
- Is insulinoma malignant?
Although most of the islet cell tumors have malignant characteristics, insulinomas is usually a benign tumor, with a very low percent of them being cancerous. Studies state that about 10% of insulinomas are malignant.
- How common is an insulinoma?
Insulinoma is a rare pancreatic endocrine tumor which incidence is rated to occur in a bot 3 to 10 cases per a million people per year. This makes up 55% of neuroendocrine tumors.
- Are insulinomas hereditary?
The majority of insulinoma patients have not inherited the condition. According to the study, for 1 in every 14 patients, insulinoma may be part of an inherited syndrome called multiple endocrine neoplasia type 1.
- What hormone is secreted in response to low blood sugar levels?
Glucagon is released to stop blood sugar levels from dropping. The release of glucagon is stimulated by low blood glucose, protein-rich meals, and adrenaline. But when the blood sugar level increases, insulin is released to bring the sugar level down.
- What is the lowest blood sugar level before a coma?
If your blood sugar level drops below 20mg/dL, you may lose consciousness and go into a coma.
If you have symptoms of severe low blood sugar (dizziness, excessive sweating, blurred vision, confusion, mood swings, seizures, etc), seek immediate medical care.
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