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Clinical characteristics and incidence of glucose metabolism disorders during the follow-up of surgically treated insulinomas

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Abstract

Purpose

Insulinomas are pancreatic endocrine tumors characterized by hypoglycemia resulting from hypersecretion of insulin. The long-term impact of surgical treatment of insulinomas, particularly the risk of glucose metabolism disorders, remains largely unknown.

Methods

We retrospectively evaluated all patients with insulinoma submitted to surgery at Centro Hospitalar Universitário de São João (Porto, Portugal) between 1980 and 2016. We evaluated baseline characteristics of patients at presentation, imaging evaluation, surgical treatment, characteristics of the tumors, perioperative complications, disease remission, and long-term follow-up and metabolic outcomes.

Results

Twenty-eight patients with insulinomas submitted to surgical treatment were included. Sixty-one percent were female, and the average age was 46.4 years. The most reported symptoms were confusion (72%) and diaphoresis (56%). The most used imaging technique was abdominal CT (72%), and the test with the highest percentage of positive results was endoscopic ultrasound (80%). The most used surgical procedure was partial pancreatic resection (71%). The mean tumor diameter was 2.1 cm and 11% of the tumors had lymph node involvement at diagnosis. Pancreatic fistula was the most common postoperative acute complications (21%). After surgery, patients were followed for a median time of 80 months (25th–75th percentile: 20–148 months). Eight patients (32%) developed glucose metabolism disorders (seven developed diabetes and one prediabetes). One of these patients developed albuminuria, and no macrovascular complications were observed during the follow-up.

Conclusions

Disorders of glucose metabolism are a frequent complication during follow-up of surgically treated insulinomas. The prevention, early diagnosis, and treatment of diabetes should be a priority in the follow-up of these patients.

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Data availability

The data sets analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal

    João Sérgio Neves, Vanessa Guerreiro, Eva Lau, Ana Isabel Oliveira, Paula Freitas & Davide Carvalho

  2. Departamento de Cirurgia e Fisiologia, Unidade de Investigação Cardiovascular, Faculdade de Medicina, Universidade do Porto, Porto, Portugal

    João Sérgio Neves

  3. Department of Internal Medicine, Centro Hospitalar entre Douro e Vouga, Santa Maria da Feira, Portugal

    Luís Teles

  4. Faculdade de Medicina, Universidade do Porto, Porto, Portugal

    Vanessa Guerreiro, Eva Lau, José Manuel Lopes, Paula Freitas & Davide Carvalho

  5. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal

    Eva Lau, José Manuel Lopes, Paula Freitas & Davide Carvalho

  6. Department of Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal

    Luís Graça

  7. Department of Pathology and Oncology, Centro Hospitalar Universitário de São João, Porto, Portugal

    José Manuel Lopes

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  1. João Sérgio Neves
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  4. Eva Lau
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  8. Paula Freitas
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  9. Davide Carvalho
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Correspondence to João Sérgio Neves.

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Neves, J.S., Teles, L., Guerreiro, V. et al. Clinical characteristics and incidence of glucose metabolism disorders during the follow-up of surgically treated insulinomas. Endocrine 71, 351–356 (2021). https://doi.org/10.1007/s12020-020-02520-0

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  • DOI: https://doi.org/10.1007/s12020-020-02520-0

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