Effects of octreotide on circulating islet B cell products in endogenous hyperinsulinism

Krentz, Andrew J.; Pace, J. E.; Somerville, Walter; Clark, P. M. S.; Nattrass, M.

doi:10.1136/pgmj.69.815.735

Cited by 3 publications

(1 citation statement)

References 16 publications

(2 reference statements)

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“…Another case of endogenous hyperinsulinism caused by a benign b-cell disorder but not insulinoma, in which hypoglycemia was successfully controlled by 50 mg of octreotide once daily, was also an 80-year-old man [21]. Although the metabolism and excretion of octreotide has not been investigated in detail, a preliminary study reported that hepatic extraction of octreotide was estimated to be between 30 and 40% in healthy volunteers [20].…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Insulinoma by a Single Daily Dose of Octreotide in Two Elderly Female Patients

et al. 2006

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Abstract. We report two cases of insulinoma in advanced age patients considered unsuitable for surgery, in whom single daily doses of octreotide successfully improved hypoglycemia and hyperinsulinemia. The biological half-life of octreotide is about 100 min, hence it is customary to use two or three administrations per day to prevent hypoglycemia in insulinoma patients. The first case was a 76-year-old woman who presented with hyperinsulinemic hypoglycemia. Computed tomography (CT) and magnetic resonance imaging did not identify a tumor in the pancreas but a 1.5-cm tumor was found in the pancreatic body on abdominal angiography and selective arterial calcium stimulation and hepatic venous sampling (ASVS) were compatible with insulinoma. The patient refused surgery, but was successfully treated with octreotide at 50 mg subcutaneous injection once daily. Since the treatment was started (1 year), she has not suffered hypoglycemia. Case 2 was an 85-year-old woman who presented with hyperinsulinemic hypoglycemia. CT identified a 1.5-cm tumor in the pancreatic uncus, but she was considered unsuitable for surgery due to advanced age, obesity and cardiopulmonary dysfunction. Octreotide at 100 mg subcutaneous injection once daily prevented further hypoglycemic attacks, but two months later, postprandial plasma glucose was elevated. Octreotide was gradually reduced to 50 mg once daily. Three years have passed since the treatment without any hypoglycemic attack. Successful treatment with octreotide once daily could be due to old-age-related slow metabolism and could be potentially considered as the treatment of choice for elderly patients with insulinoma especially those considered unsuitable for surgery.

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Section: Discussionmentioning

confidence: 99%

Successful Treatment of Insulinoma by a Single Daily Dose of Octreotide in Two Elderly Female Patients

et al. 2006

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Classic endocrine disorders: implications for cardiovascular disease

Krentz¹

2023

Cardiovascular Endocrinology and Metabolism

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Somatostatin analogues for the treatment of hyperinsulinaemic hypoglycaemia

Haris

Saraswathi

Hussain

2020

Therapeutic Advances in Endocrinology

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Hyperinsulinaemic hypoglycaemia (HH) is a biochemical finding of low blood glucose levels due to the dysregulation of insulin secretion from pancreatic β-cells. Under normal physiological conditions, glucose metabolism is coupled to β-cell insulin secretion so that blood glucose levels are maintained within the physiological range of 3.5–5.5 mmol/L. However, in HH this coupling of glucose metabolism to insulin secretion is perturbed so that insulin secretion becomes unregulated. HH typically occurs in the neonatal, infancy and childhood periods and can be due to many different causes. Adults can also present with HH but the causes in adults tend to be different. Somatostatin (SST) is a peptide hormone that is released by the delta cells (δ-cells) in the pancreas. It binds to G protein-coupled SST receptors to regulate a variety of location-specific and selective functions such as hormone inhibition, neurotransmission and cell proliferation. SST plays a potent role in the regulation of both insulin and glucagon secretion in response to changes in glucose levels by negative feedback mechanism. The half-life of SST is only 1–3 min due to quick degradation by peptidases in plasma and tissues. Thus, a direct continuous intravenous or subcutaneous infusion is required to achieve the therapeutic effect. These limitations prompted the discovery of SST analogues such as octreotide and lanreotide, which have longer half-lives and therefore can be administered as injections. SST analogues are used to treat different forms of HH in children and adults and therapeutic effect is achieved by suppressing insulin secretion from pancreatic β-cells by complex mechanisms. These treatments are associated with several side effects, especially in the newborn period, with necrotizing enterocolitis being the most serious side effect and hence SS analogues should be used with extreme caution in this age group.

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Effects of octreotide on circulating islet B cell products in endogenous hyperinsulinism

Cited by 3 publications

References 16 publications

Successful Treatment of Insulinoma by a Single Daily Dose of Octreotide in Two Elderly Female Patients

Successful Treatment of Insulinoma by a Single Daily Dose of Octreotide in Two Elderly Female Patients

Classic endocrine disorders: implications for cardiovascular disease

Somatostatin analogues for the treatment of hyperinsulinaemic hypoglycaemia

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