Fluctuations in Plasma Proinsulin in an Insulinoma: Implications for Screening Test

E, Ipp; Rh, Tarris; Sm, Griffiths; Db, Zhou; Rr, Bowsher; Me, Terlecki

doi:10.2337/diacare.15.7.931

Cited by 2 publications

(1 citation statement)

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“…The orderly subcellular progression of proinsulin to insulin conversion in a normal patient can be disordered in the insulinoma patient [8, 9]. Measuring specific proinsulin levels, despite possible fluctuations in plasma levels, can potentially aid in the diagnosis of insulinomas [10]. Proinsulin‐like component, which includes proinsulin and its intermediates, can help as a confirmatory test [11].…”

Section: Discussionmentioning

confidence: 99%

Multiple Proinsulin‐Secreting Tumors of the Pancreas Treated by Laparoscopic Distal Pancreatectomy and Splenectomy

2008

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Section: Discussionmentioning

confidence: 99%

Multiple Proinsulin‐Secreting Tumors of the Pancreas Treated by Laparoscopic Distal Pancreatectomy and Splenectomy

2008

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Erratic Oscillatory Characteristics of Plasma Insulin Concentrations in Patients with Insulinoma: Mechanism for Unpredictable Hypoglycemia¹

Berman

Genter

Chou

et al. 1997

The Journal of Clinical Endocrinology & Metabolism

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Patients with insulin-producing tumors may have hypoglycemic symptoms at unpredictable times. This study evaluated whether plasma insulin oscillations, known to occur in normal individuals but not explored in patients with insulinomas, could be an underlying mechanism for such events. Nine normal subjects and five patients with proven insulinomas were studied in the fasting state. Serial sampling of arterialized blood over 80-100 min, at 2- or 3-min intervals was performed. In normal subjects, mean plasma glucose and insulin concentrations were 5.3 +/- 0.1 mmol/L and 58 +/- 9 pmol/L, respectively. Regular, low-amplitude plasma insulin oscillations were observed, with a period of 10-17 min. The subjects with insulinomas had lower mean plasma glucose and higher insulin concentrations than controls, 3.6 +/- 0.3 mmol/L (P = 0.01) and 150 +/- 42 pmol/L (P = 0.01), respectively. They also had insulin oscillations that appeared unstable as a result of variability in duration and amplitude compared with controls. The insulin pulses were irregular, and interpeak intervals varied between 4-54 min in different subjects; in some subjects, the amplitude was also variable, with sudden spontaneous pulses as high as 565 pmol/L, with an associated glucose decrement. We conclude that large spontaneous bursts of insulin secretion occur in patients with insulinomas as part of an erratic pattern of oscillatory insulin secretion, and these can account for unpredictable occurrences of hypoglycemia.

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Fluctuations in Plasma Proinsulin in an Insulinoma: Implications for Screening Test

Cited by 2 publications

References 4 publications

Multiple Proinsulin‐Secreting Tumors of the Pancreas Treated by Laparoscopic Distal Pancreatectomy and Splenectomy

Multiple Proinsulin‐Secreting Tumors of the Pancreas Treated by Laparoscopic Distal Pancreatectomy and Splenectomy

Erratic Oscillatory Characteristics of Plasma Insulin Concentrations in Patients with Insulinoma: Mechanism for Unpredictable Hypoglycemia¹

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Fluctuations in Plasma Proinsulin in an Insulinoma: Implications for Screening Test

Cited by 2 publications

References 4 publications

Multiple Proinsulin‐Secreting Tumors of the Pancreas Treated by Laparoscopic Distal Pancreatectomy and Splenectomy

Multiple Proinsulin‐Secreting Tumors of the Pancreas Treated by Laparoscopic Distal Pancreatectomy and Splenectomy

Erratic Oscillatory Characteristics of Plasma Insulin Concentrations in Patients with Insulinoma: Mechanism for Unpredictable Hypoglycemia1

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Erratic Oscillatory Characteristics of Plasma Insulin Concentrations in Patients with Insulinoma: Mechanism for Unpredictable Hypoglycemia¹