Insulinoma: сlinical surveillance in physician’s outpatient practice

Insulinoma is one of the most common neuroendocrine tumors. As a result of endogenous organic hyperinsulinism, a hypoglycemic symptom complex develops, characterized by an attack of hunger, sweating, trembling, severe weakness and headache. To diagnose insulinoma and provide timely medical care during an attack of hypoglycemia, it is necessary to quickly and accurately measure blood glucose, not only in the laboratory, but also at home, which can be done using a glucometer. One of the most important aspects of measuring blood glucose, especially when severe hypoglycemia occurs, is the accuracy of the meter. Monitoring blood glucose during symptoms of hypoglycemia is possible with the help of an accurate, simple and convenient means of determining blood glucose, one of which is the Contour Plus One glucometer. Thanks to the improvement of technologies used in the Contour Plus One glucometer, the accuracy of blood glucose measurements increases, the procedure for glycemic control is simplified, which speeds up the provision of necessary medical care for hypoglycemia in patients with insulinoma. Accurate and rapid glucose control is necessary not only for diagnosing insulinoma, but also for self-monitoring of glycemia in patients with diabetes mellitus (DM). In addition to glycemic control, imaging studies that include computed tomography (CT), magnetic resonance imaging (MRI), transabdominal and endoscopic ultrasound, and molecular imaging methods are used to clarify the diagnosis of insulinoma. The radical treatment method is surgery, namely enucleation of the tumor or resection of part of the pancreas. In the vast majority of cases, surgery provides a complete cure. Conservative treatment tactics are considered when severe comorbidities and the patient's overall health status significantly exceed the risk of surgical intervention. The presented clinical observation demonstrates the classic clinical manifestations of insulinoma, the main laboratory and instrumental diagnostic methods: measuring blood glucose, including at home, using an accurate, simple and convenient glucometer Contour Plus One, fasting test, MRI, contrast-enhanced CT and immunohistochemical study. This clinical case of insulinoma is recommended for study by doctors of various specialties, primarily endocrinologists, oncologists and therapists.