Glucose-responsive and Octreotide-sensitive Insulinoma

Izumiyama, Hajime; Gotyo, Naoki; Fukai, Nozomi; Ozawa, Naoko; Doi, Masaru; Yoshimoto, Takanobu; Arii, S.; Hirata, Yukio

doi:10.2169/internalmedicine.45.1523

Cited by 12 publications

(4 citation statements)

References 28 publications

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“…However, somatostatin analogues are rarely used for long-term therapy in patients with endogenous hyperinsulinism and the available medical literature on this topic comprises only case reports. [9][10][11][12][13][14][15][16][17] This prospective study set out to provide efficacy and tolerability data in this field by evaluating the response to the somatostatin analogue, octreotide, in patients with endogenous hyperinsulinism who could not benefit from a surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

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Short‐ and long‐term somatostatin analogue treatment in patients with hypoglycaemia related to endogenous hyperinsulinism

Vezzosi¹,

Bennet²,

Courbon

et al. 2007

Clinical Endocrinology

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Summary Background The long‐term efficacy of somatostatin analogues on insulinomas has not been studied. Design A prospective study to evaluate the response of octreotide in 21 patients with hypoglycaemia related to endogenous hyperinsulinism who were not treated by surgery. Results Reasons for not undergoing surgery were: refusal (n = 3), old age with multiple diseases (n = 5), unlocalized insulinomas (n = 2), malignant unresectable insulinomas (n = 5), multiple insulinomas (n = 3) and diffuse β‐cell disease (n = 3). Hypoglycaemia was responsive to octreotide in 14 of the 21 patients. A short 100‐µg octreotide test correctly predicted the efficacy of treatment in six patients with benign insulinomas. Octreoscan scintigraphy was positive in 6 of the 16 patients of whom three were responsive and three unresponsive to octreotide. Octreoscan scintigraphy was negative in 10 of the 16 patients, eight of whom were responsive to octreotide. Subcutaneous octreotide treatment was prolonged for > 6 months (7–144 months, 67 ± 47 months) in 11 responsive patients. No tachyphylaxis was observed. However, the octreotide dose had to be increased in two patients after 3 and 18 months, respectively. Only one patient suffered from symptomatic biliary lithiasis after 3 years of treatment. Conclusion Long‐term octreotide treatment can be used to control hypoglycaemia in patients with endogenous hyperinsulinism who are not eligible for surgery; octreotide efficacy on hypoglycaemia could be predicted by a short 100 µg‐octreotide test in patients with benign insulinomas, but was not correctly predicted by Octreoscan scintigraphy.

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Section: Discussionmentioning

confidence: 99%

“…• Short-term octreotide treatment. The response to short-term octreotide treatment was evaluated in 16 patients after between 1 week and 2 months of treatment (patients 1-3, 5, 6,9,11,[13][14][15][16][17][18][19][20][21]. The final dose of octreotide was 621 ± 619 μ g /day (50-2000 μ g /day).…”

Section: Methodsmentioning

confidence: 99%

Short‐ and long‐term somatostatin analogue treatment in patients with hypoglycaemia related to endogenous hyperinsulinism

Vezzosi¹,

Bennet²,

Courbon

et al. 2007

Clinical Endocrinology

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“…The consequences may be huge and serious diseases that may include, chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). 1 , 2 Renal glycosuria is not gender-biased, although males seem to be more prone to the condition than females. 3 It is suggested that the renal threshold falls with age in some individuals and rare in children; also infants have immature organs (kidney) such that it functions at low efficiency.…”

Section: Introductionmentioning

confidence: 97%

Gender-Inclined Young Age Glycosuria: Contribution to Late Age Chronic Renal Diseases, Type 2 Diabetes Mellitus and Cardiovascular Diseases

Mng’agi,

Mwandigha

2023

EAHRJ

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Background: Chronic kidney diseases (CKD), Type 2 Diabetes Mellitus (T2DM) and cardiovascular diseases (CVDs) are the recent worldwide late age chronic conditions that could be a consequence of renal glycosuria during childhood. This study aimed at determining the extent of glycosuria in secondary school students to obtain information that could be predictive of the situation in late age life of Tanzanians living in Mkuranga District. Methodology: This was school-based cross-sectional study that was conducted in assenting and consenting 800 students from July to October 2019 in Mkuranga district, Pwani-Tanzania. Socio-demographic information was collected using well-structured questionnaires while weight and height were measured using beam balance and tape measure, respectively. Dipstick strip was used to determine urine glucose on clean catch mid-stream urine collected specimens. Results: From a total of 800 enrolled students, 0.6% (5/800) had glycosuria from whom 80% were males and 20% (1/5) were females (p = 0.37). The proportion of glycosuric males was 4 folds higher than that found in females. While height, body mass index (BMI) and waist–hip circumference ratio were associated with renal glycosuria (p < 0.05), other factors showed no association (p > 0.05). Conclusion: Despite the low proportion (0.6%) of glycosuria in this study, the contribution of young age renal glycosuria to old age CKD, T2DM and CVDs cannot be ruled out with males being more prone than females. Thus, it signals for consideration of regular screening for glycosuria in the school health programmes as an intervention strategy to prevent potential late age chronic disease complications.

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“…Post-prandial hypoglycaemia without fasting hypoglycaemia is now known to occur in some insulinoma patients (6% according to Placzkowski et al 2009) and in patients with noninsulinoma pancreatogenous hypoglycaemia , a syndrome which is part of nesidioblastosis (see below). Others have reported false negative tests in insulinoma patients who are correctly diagnosed after a meal test or oral glucose tolerance test (Sjoberg & Kidd 1992) (Izumiyama et al 2006;Kar et al 2006). A mixed meal test was shown to be preferable to the oral glucose tolerance test (Hogan et al 1983), so that only the meal test was recommended in the 2009 expert consensus.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment of Insulinomas in the Adults

Vezzosi¹,

Bennet²,

Maïza³

et al. 2011

Basic and Clinical Endocrinology Up-to-Date

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Glucose-responsive and Octreotide-sensitive Insulinoma

Abstract: Insulinoma is the most common cause of fasting hypoglycemia resulting from autonomous insulin hyper

Cited by 12 publications

References 28 publications

Short‐ and long‐term somatostatin analogue treatment in patients with hypoglycaemia related to endogenous hyperinsulinism

Short‐ and long‐term somatostatin analogue treatment in patients with hypoglycaemia related to endogenous hyperinsulinism

Gender-Inclined Young Age Glycosuria: Contribution to Late Age Chronic Renal Diseases, Type 2 Diabetes Mellitus and Cardiovascular Diseases

Diagnosis and Treatment of Insulinomas in the Adults

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