Insulinomas have an incidence of approximately one in one million people. They account for 66 to 85 per cent of patients with endogenous hyperinsulinism. They usually have dimensions of 1 to 2 cm and 99 per cent of them occur within the mass of the pancreas; 5 to 10 per cent are malignant. Typical symptoms of hypoglycemia tend to occur in the late afternoon or some hours after a meal. Diagnosis requires demonstration of Whipple's triad: low serum glucose, spontaneous symptoms during documented hypoglycemia, and resolution of symptoms with glucose administration. Rare non-b-cell tumors can cause related syndromes. Most are mesenchymal, but occasional epithelial neoplasms such as hepatomas and adrenocortical and carcinoid tumors can cause hypoglycemia.
I. C. Sanderson, M. G. Mythen Introduction
Diagnosis, and clinical,, presentation Management Glucagon
Other pharmacological options
Thiamine. and ..Wernicke's encephalopathy
Post-hypoglycemic. .coma Chapter.. Reference
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