Is the Size of Insulinoma Predictive for its Endocrine Behavior?
                        An Endoscopic Ultrasound Study

Adelmeyer, Jan; Göbel, Franziska; Kann, Peter Herbert

doi:10.1055/a-1840-7492

Cited by 3 publications

(2 citation statements)

References 39 publications

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“…This is important to know, especially in situations where an insulinoma is suspected, and various lesions in the pancreas are detected by imaging, as for example in MEN1. Homogenous tumor echogenicity seems to be an indicator for higher differentiation related to more severe clinical symptoms [ 42 ].…”

Section: Insulinomamentioning

confidence: 99%

Relevance of Endoscopic Ultrasound in Endocrinology Today: Multiple Endocrine Neoplasia Type 1, Insulinoma, Primary Aldosteronism—An Expert’s Perspective Based on Three Decades of Scientific and Clinical Experience

Kann

2023

Cancers

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In endocrinology, endoscopic ultrasound (EUS) may be used to image the adrenals, the endocrine pancreas, and other organs where endocrine neoplasms may occur. During the recent decades, EUS has been established predominantly to assess multiple endocrine neoplasia type 1, to localize insulinomas, and to identify aldosterone-producing adenomas. EUS in endocrinology requires special skills and individual experience in order to provide reliable diagnostic information.

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Section: Insulinomamentioning

confidence: 99%

Relevance of Endoscopic Ultrasound in Endocrinology Today: Multiple Endocrine Neoplasia Type 1, Insulinoma, Primary Aldosteronism—An Expert’s Perspective Based on Three Decades of Scientific and Clinical Experience

Kann

2023

Cancers

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“…At our center, we have extensive expertise in the diagnosis and treatment of patients with insulinomas [14,15]. However, we have noticed that we are seeing many more patients than actually have an internal medicine diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous hypoglycemia: Should we mind the gap? Long-term follow-up of healthy people who met Whipple´s Triad

Adelmeyer

Schauer

Kann

2023

Preprint

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Context: Patients discharged as “healthy” with the symptom of spontaneous hypoglycemia need more attention.Objective Characterization and long-term follow-up of these patientsMethods Retrospective analysis and questionnaire follow-upSetting: Center for Endocrinology, Diabetology and Osteology at the University Hospital Marburg, Inpatient DepartmentPatients: All patients who presented to our center for the 72-hour fast between 2005 and 2018 and were discharged without an internal medicine diagnosis were included.Interventions: Survey by questionnaireMain outcome measures: Patient-reported information about current symptoms compared to original symptoms, diagnosis of insulinoma or diabetes mellitus during follow-up, matched with primary care physician data, metabolic and biometric data such as body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA IR), insulin sensitivity Matsuda Index (ISI-M) and area under the curveResults A total of 41 data sets were evaluated at baseline and 38 patients were followed for an average of approximately 10 years. 61% of respondents still reported the same symptoms as at baseline. No insulinoma was missed in these patients. Only two of the 38 patients developed diabetes mellitus.Conclusion The high percentage of patients who are discharged as "healthy" and still have symptoms after many years is disturbing. It is possible that the symptoms are not due to low blood glucose. We urge caution with the term "healthy". In addition, more research should be done on this topic.

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Spontaneous hypoglycemia: should we mind the gap? Long-term follow-up of healthy people who met Whipple’s triad criteria

Adelmeyer,

Schauer,

Kann

2024

Hormones

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Context Patients discharged as “healthy” with the symptoms of spontaneous hypoglycemia, commonly known as Whipple’s triad, need more attention. Objective Characterization and long-term follow-up of symptom development in patients with spontaneous hypoglycemia discharged as “healthy”. The objective was to ascertain whether any conditions related to the symptoms were diagnosed during the follow-up period. Methods Retrospective analysis of patient data and evaluation of a specific questionnaire on the development of symptoms of spontaneous hypoglycemia. In addition, patient questionnaires were evaluated and primary care physicians were asked about possible diseases not recorded at baseline that occurred during the follow-up period. Setting Center for Endocrinology, Diabetology, and Osteology at the University Hospital Marburg, Inpatient Department, Germany. Patients All patients who presented to our center for the 72-hour fast between 2005 and 2018 and were discharged without an internal medicine diagnosis were included. Interventions Survey by questionnaire, via telephone interview. Main outcome measures Patient-reported information on current symptoms compared to original symptoms, diagnosis of insulinoma or diabetes mellitus during follow-up, matched with primary care physician data, and metabolic and biometric data such as body mass index (BMI), homeostasis model assessment for insulin resistance (HOMA IR), insulin sensitivity Matsuda Index (ISI-M), and area under the curve. Results A total of 41 datasets were evaluated at baseline and 38 patients were followed for an average of approximately 10 years. In total, 61% of respondents still reported the same symptoms as at baseline. No insulinoma was missed in these patients. Only two of the 38 patients developed diabetes mellitus. Conclusion The high percentage of patients who are discharged as “healthy” and still have symptoms after many years is disturbing. It is possible that the symptoms are not due to low blood glucose. We urge caution with use of the term “healthy”. We advocate a multidisciplinary therapeutic approach after an organic cause of hypoglycemia has been ruled out. Psychosomatic treatment seems to be useful. In addition, more research should be conducted on this topic.

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Is the Size of Insulinoma Predictive for its Endocrine Behavior? An Endoscopic Ultrasound Study

Cited by 3 publications

References 39 publications

Relevance of Endoscopic Ultrasound in Endocrinology Today: Multiple Endocrine Neoplasia Type 1, Insulinoma, Primary Aldosteronism—An Expert’s Perspective Based on Three Decades of Scientific and Clinical Experience

Relevance of Endoscopic Ultrasound in Endocrinology Today: Multiple Endocrine Neoplasia Type 1, Insulinoma, Primary Aldosteronism—An Expert’s Perspective Based on Three Decades of Scientific and Clinical Experience

Spontaneous hypoglycemia: Should we mind the gap? Long-term follow-up of healthy people who met Whipple´s Triad

Spontaneous hypoglycemia: should we mind the gap? Long-term follow-up of healthy people who met Whipple’s triad criteria

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