Summary
A collective review of 132 cases of insulin-secreting tumors of the pancreas treated by medical measures is reported. The most widely used drugs were diazoxide, corticoids and streptozotocin which have been effective in controlling hypoglycemia respectively in 48 out of 88 cases, in 15 out of 43 cases and in 10 out of 18 cases. Other drugs were of benefit only in a few cases, or were not sufficiently investigated. Results of treatment, evaluation of toxicity and incidence of side-effects suggest that the drug of choice in the treatment of insulinomas is diazoxide. Streptozotocin must be employed only in patients with malignant disease. The role and indications of medical management in patients with insulinomas are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bleicher S. I., Chowdhury F., Goldner M. G.: Thyazide Therapy in Hypoglycemia of Metastatic Insulinoma — Clin. Res.12, 456, 1964.
Broder L. E., Carter S. K.: Pancreatic Islet-Cell Carcinoma. Results of Therapy with Streptozotocin in 52 Patients — Ann. inter. Med.79, 101, 1973.
Clarke M., Crofford O. B., Graves H. A. Jr., Scott H. W. Jr.: Functioning Beta Cell Tumors (Insulinomas) of the Pancreas — Ann. Surg.175, 956, 1972.
Ernest M., Mitchell M. L., Raben M. S., Gilboa Y.: Control of Hypoglycemia with Diazoxide and Human Growth Hormone — Lancet1, 628, 1965.
Federspil G., Zaccaria M., Sicolo N., Casara D., Erle G., Scandellari C.: La terapia medica delle ipoglicemie spontanee — Arch. Atti Soc. It. Endocrinol. Montecatini, 1972; vol. 1, p. 153.
Graber A. L., Porte D. Jr., Williams R. H.: Clinical Use of Diazoxide and Mechanism for its Hyperglycemic Effects — Diabetes15, 143, 1966.
Howard J. M., Moss H., Rhoads J. E.: Collective Review: Hyperinsulinism and Islet-Cell Tumors of the Pancreas. With 398 Recorded Tumors — Surg. Gynec. Obstet.90, 417, 1950.
Landau B. R., Levine H. J., Hertz R.: Prolonged Glucagon Administration in Case of Hyperinsulinism Due to Disseminated Islet-Cell Carcinoma — New Engl. J. Med.259, 286, 1958.
Laroche G. P., Ferris D. O., Priestley J. T., Scholz D. A., Dockerty M. B.: Hyperinsulinism. Surgical Results and Management of Occult Functioning Islet-Cell Tumors: Review of 154 Cases — Arch. Surg.96, 763, 1968.
Laurent J., Debry G., Floquet J.: Hypoglycemic Tumors — Excerpta Medica Foundation, Amsterdam, 1971; pp. 74 and 78.
Loubatières A., Mariani M.-M., Ribes G.: Bases expérimentales pharmacodynamiques et cliniques du traitement de l’hypoglycémie par le diazoxide — Presse méd.75, 725, 1967.
Mengoli L., Le Quesne L. P.: Blind Pancreatic Resection for Suspected Insulinoma: a Review of the Problem — Brit. J. Surg.54, 749, 1967.
Stanley N. N.: Malignant Insulinoma Treated with Streptozotocin — Proc. roy. Soc. Med.64, 302, 1971.
Stefanini P., Carboni M., Patrassi N., Basoli A.: Beta-Islet Cell Tumors of the Pancreas: Results of a Statistical Study of 1067 Cases Collected — Surgery75, 597, 1974.
Stefanini P., Carboni M., Patrassi N., Basoli A.: The Surgical Treatment of Occult Insulinomas: a Review of the Problem — Brit. J. Surg.61, 1, 1974.
Warren K. W.: Islet-Cell Tumors and Hyperinsulinism — Surg. Clin. N. Amer.42, 709, 1962.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Stefanini, P., Carboni, M., Patrassi, N. et al. Problems of the management of insulinomas. Review of 132 cases treated with medical measures. Acta diabet. lat 11, 71–77 (1974). https://doi.org/10.1007/BF02581941
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02581941