Which clinical history findings are characteristic of insulinoma?

Updated: May 31, 2020
  • Author: Zonera Ashraf Ali, MBBS; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

Features of the history in patients with insulinoma are as follows:

  • About 85% of patients present with symptoms of hypoglycemia that include diplopia, blurred vision, palpitations, or weakness.

  • Other symptoms include confusion, abnormal behavior, unconsciousness, or amnesia.

  • About 12% of patients have grand mal seizures.

  • Adrenergic symptoms (hypoglycemia causes adrenalin release) include weakness, sweating, tachycardia, palpitations, and hunger.

  • Symptoms may be present from 1 week to as long as several decades prior to the diagnosis (1 mo to 30 y, median 24 mo, as found in a large series of 59 patients). [17] Symptoms may occur most frequently at night or in the early morning hours.

  • Hypoglycemia usually occurs several hours after a meal.

  • In severe cases, symptoms may develop in the postprandial period. Symptoms can be aggravated by exercise, alcohol, hypocaloric diet, and treatment with sulfonylureas.

  • Weight gain occurs in 20-40% of cases, because patients may eat frequently to avoid symptoms.

  • Case reports describe patients with type 2 diabetes who develop hypoglycemia from insulinoma [18, 19]

  • Symptoms caused by effects of local tumor mass are very rare in insulinoma.

Most patients with insulinoma have normal physical examination findings.


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