Insulinoma (Beta cell tumour of Pancreas)

What Is an Insulinoma?

Small tumour (single or multiple) in Beta cells of pancreas called Insulinoma, which produce excess amount of Insulin resulting in Hypo-glycaemia or low blood sugar, but these tumours are not cancerous.
The pancreas is an endocrine gland situated behind the stomach, its main function is to produce Insulin (from beta cells) to control blood sugar level.
If unfortunately Insulinoma forms in pancreas, it forcibly secretes more insulin then needed to manage blood sugar level , which leads to life threatening low blood sugar level or hypoglycaemia. About 90-95% insulinoma are benign 5-7 % are malignant and found in 1 case/million person.

  • Sex – Male & female in ratio 2:3.
  • Age – Most cases diagnosed about the age between 40-60 years.
  • Causes of Insulinoma – When and why Insulinoma produces is not clear to the medical science till date, except genetically caused by MEN-1 syndrome.
  • Size of Insulinoma – Less than 2 cm could be single of multiple.
  • Symptoms of an Insulinoma – Divided in two parts
Mild –
  • ◘ Blurred vision or Double vision
  • ◘ Confusion
  • ◘ Anxiety and irritability
  • ◘ Dizziness
  • ◘ Mood swings
  • ◘ Weakness
  • ◘ Sweating
  • ◘ Hunger
  • ◘ Tremors
  • ◘ Sudden weight gain
Severe –
  • ◘ Convulsions or seizures
  • ◘ Increased heart rate (greater than 95 beats per minute )
  • ◘ Difficulty in concentrating
  • ◘ Loss of consciousness or coma (can affect the brain also), Symptoms may aggravate by exercise, alcohol, hypo-calorie diet and treatment with sulphonylurea or Sulfonylureas.
Lab. Investigation –
  • ◘ Serum insulin levels of 10 µU/mL or more (normal <6 µU/mL)
  • ◘ Glucose levels of less than 40 mg/dL.
  • ◘ C-peptide levels exceeding 2.5 ng/mL (normal <2 ng/mL).
  • ◘ Pro-insulin levels ≥22 pmol/L or greater than 25% (or up to 90%) that of immuno reactive insulin.
  • ◘ Screening for sulfonylurea negative.
Imaging Studies–
  • Endoscopic ultrasonography detects approx. 80% Insulinoma, while ultrasound, CT & MRI confers less 50 % or above.
  • Medical Treatment – Diazoxide in different doses, Somatostatin analogue, Glucagon and Streptozocin etc are given under medical advice , but these may have many adverse effects also.
  • Surgical Treatment – Surgical removal of the tumour is said to be best, while a small part of the pancreas may also be removed if multiple tumours exists. Most of the people recover completely without complications. Recurrence is more common in people who have multiple tumours.
    Cryosurgery is a type of surgery that involves the use of extreme cold to destroy abnormal tissues, such as tumours.
  • Complication of surgical procedure – Pseudo-cysts, Pancreatitis, Abscess, Intestinal complications, Pleural effusion, Haemorrhage and fistula formation and permanent diabetes mellitus.
  • Successful Ayurvedic treatment – Fresh juice of cynodon dactylon (conch Grass) 1-5 tea spoonful may give satisfactory results within 1-5 hrs. A patent herbo-mineral preparations according to patient’s genetic nature, reduces the oxidative stress and also reduces the episodes of low sugar and also retards the post operational recurrences of tumours in pancreas, and found ‘No any side effect noticed’.
    Additional benefits of Ayurvedic medicines – It works as natural potent antioxidant and anti aging agent, and provides relief in all clinical symptoms after 10-12 days with feeling of energetic in total health and well being.
  • Risk factors for an Insulinoma - There are few risk factors for Insulinoma. But, women seem to be affected more as compare to men. Most often, it starts between ages 40 to 60. Some genetic diseases can raise your chance of getting an Insulinoma are as under –
  • ◘ Multiple endocrine neoplasia type 1, abnormal tissue growth in the endocrine system.
  • ◘ Von Hippel-Lindau syndrome, an inherited disease that causes tumours and cysts throughout your body.
  • ◘ Other genetic syndromes, such as neurofibromatosis type 1 and tuberous

Key points-

  • ◘ Insulinoma’s are tumour in your pancreas. They make extra insulin, more than your body can use.
  • ◘ Insulinoma’s can cause hypo-glycaemia, or low blood sugar.
  • ◘ Low blood sugar can cause confusion, sweating, weakness, and a rapid heartbeat. If your blood sugar gets too low, you can pass out and even go into a coma.
  • ◘ Almost all Insulinoma’s are not cancerous.
  • ◘ Removing the tumour cures the condition.