ArticleJournal of endocrinological investigation2013
Presentation, diagnostic features and glucose handling in a monocentric series of insulinomas.
Article in Journal of endocrinological investigation, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- ENETS Consensus Guidelines Update for the Management of Patients with Functional Pancreatic Neuroendocrine Tumors and Non-Functional Pancreatic Neuroendocrine Tumors.Neuroendocrinology · 2016Guideline
- Diagnosis and Management of Functional Pancreatic Neuroendocrine Tumors in Children-A Systematic Review.Diagnostics (Basel, Switzerland) · 2025Review
- Diagnosis and management of benign secreting pancreatic insulinoma: What's new? 4 case report.Rare tumors · 2025Article
- Genotype-histotype-phenotype correlations in hyperinsulinemic hypoglycemia.Histology and histopathology · 2024Review
- Insulinoma-related Endogenous Hypoglycaemia with a Negative Fasting Test: A Case Report and Literature Review.European journal of case reports in internal medicine · 2022Article
- Carcinoid Syndrome and Hyperinsulinemic Hypoglycemia Associated with Neuroendocrine Neoplasms: A Critical Review on Clinical and Pharmacological Management.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Gastroenteropancreatic neuroendocrine neoplasms: A clinical snapshot.World journal of gastrointestinal surgery · 2021Review
- The functioning side of the pancreas: a review on insulinomas.Journal of endocrinological investigation · 2020Review
- Adult Nesidioblastosis in Chronic Kidney Disease.Case reports in endocrinology · 2019Article
- Incidence and management of postoperative hyperglycemia in patients undergoing insulinoma resection.Endocrine · 2018Article
- Italian Association of Clinical Endocrinologists (AME) position statement: a stepwise clinical approach to the diagnosis of gastroenteropancreatic neuroendocrine neoplasms.Journal of endocrinological investigation · 2014Article
- Diagnostic Modalities, Management Considerations, and Outcomes of Insulinoma: A Case Series from a Tertiary Care Centre.Indian journal of endocrinology and metabolismArticle
- Insulin Resistance Among Patients With Multiple Endocrine Neoplasia Type 1: A Systemic Review and Meta-Analysis.AACE endocrinology and diabetesArticle
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNew aspects have emerged in the clinical and diagnostic scenarios of insulinoma: current guidelines have lowered the diagnostic insulin threshold to 3 μU/ml in the presence of hypoglycemia (<55 mg/dl); post-prandial hypoglycemia has been reported as the only presenting symptom; preexisting diabetes mellitus (DM) was recognized in some patients.
aimTo evaluate clinical features, diagnostic criteria and glucose metabolic profile in a monocentric series of patients affected by insulinomas including two subgroups: sporadic and multiple endocrine neoplasia type-1 syndrome (MEN-1). SUBJECTS AND
methodsClinical, pathological and biochemical data regarding 33 patients were analyzed.
resultsfollowing the current guidelines the 72-h fasting test was initially positive in all cases but one. In this case the test, initially negative, became positive after a 2-yr follow-up. Nadir insulin level was ≥ 3 μU/ml but <6 μU/ml in 3 patients and ≥ 6 μU/ml in the remaining 30 cases. At presentation, 27 patients (82%) reported only fasting symptoms, 3 (9%) only post-prandial and 3 (9%) both. Seven cases (21%) had previously been affected by type 2 DM or impaired glucose metabolism.
conclusionsIn our series the new cut-off of insulin increased the sensitivity of the 72-h fasting test from 87% to 97%. The absence of hypoglycemia during the test cannot definitively rule out the diagnosis and the test should be repeated in every highly suspicious case. Post-prandial hypoglycemia can be the only presenting symptom. DM may be associated with the occurrence of insulinoma. So that a possible diagnosis of insulinoma must not be ignored if previous impaired glucose handling is evident.
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