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Insulinoma

By

Minhhuyen Nguyen

, MD, Fox Chase Cancer Center, Temple University

Reviewed/Revised Mar 2021 | Modified Sep 2022
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Topic Resources
The Pancreas
VIDEO

Symptoms of Insulinoma

Symptoms of insulinoma result from low levels of sugar (glucose) in the blood (hypoglycemia Hypoglycemia Hypoglycemia is abnormally low levels of sugar (glucose) in the blood. Hypoglycemia is most often caused by medications taken to control diabetes. Much less common causes of hypoglycemia include... read more ), which occur when the person does not eat for several hours (most often in the morning after an all-night fast). The symptoms include faintness, weakness, trembling, awareness of the heartbeat (palpitations), sweating, nervousness, and profound hunger. Other symptoms include headache, confusion, vision abnormalities, unsteadiness, and marked changes in personality. The low levels of sugar in the blood may even lead to a loss of consciousness, seizures, and coma.

Diagnosis of Insulinoma

  • Blood tests

  • Imaging tests

Diagnosing an insulinoma can be difficult. Doctors try to do blood tests while the person has symptoms and has not eaten. Blood tests include measurements of blood glucose levels and insulin levels. Very low levels of glucose and high levels of insulin in the blood indicate the presence of an insulinoma. Because many people have symptoms only occasionally, doctors may admit them to the hospital. In the hospital, the person fasts for at least 48 hours, sometimes up to 72 hours, and is closely monitored. During that time, the symptoms usually appear, and blood tests are done to measure the levels of glucose and insulin.

Treatment of Insulinoma

  • Surgical removal

  • Diazoxide or sometimes octreotide

  • Sometimes chemotherapy

The primary treatment for an insulinoma is surgical removal, which has a cure rate of about 90%.

When the insulinoma cannot be completely removed and symptoms continue, drugs such as diazoxide or sometimes octreotide can help keep blood glucose from falling too low. Chemotherapy drugs may help control the tumor.

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