Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2006) 11 P453

ECE2006 Poster Presentations Endocrine tumours and neoplasia (116 abstracts)

What is the best glycaemic index for the diagnostic of insulinoma?

JM Andrieu 1 , DB Bassiri 1 , RM Ramdani 2 , EG Guzman 2 , JF Fabre 3 , EA Aboud 1 & JC Courreges 1


1General Hospital, Narbonne, France; 2General Hospital, Beziers, France; 3University Hospital, Montpellier, France.


We present the observation of a patient in whom the diagnostic of insulinoma was difficult in front of normality on the classically used indexes. A 63-year-old patient, whithout any antecedent or drug used, was admitted in our service after a hypoglycaemic coma (glycaemia 1.21 mmol/l, insulinemia not measured). Clinical examination was normal. We performed a fasting testing. Results are listed in this table:

Table 1
Time7 am1 pm1 am
Glycaemia (Gly) mmol/2.92.12.50
Insulinemia (Ins) mU/l N (2 17)4.123.294.38
Ins/Gly N<2010.3411.212.78
Turner index N<5018.724729.2

Glycaemia indexes were normal, as well as the initial interpretation of abdominal scan, but, the diagnosis of insulinoma was suspected. So we performed an echo endoscopy which shows a mass of one centimeter in the pancreatic isthmus. Transgastric ponction of this mass shows a neuro-endocrine proliferation cells compatible with an insulinoma. In spite of a treatment by octreotide, hypoglycaemias was frequent and sever. The patient was sent to a surgeon who practiced a enucleo-resection with immediate result on hypoglycaemias. Insulinoma was confirmed by the anathomo-pathologist. The interest of this well-known observation is in one hand to discuss the validity of glycaemia indexes. With the new technics who detect only insulinemia and not pro-insulinemi, they are inadequat and should be left. With the new technics any insulinemia superior to 2 mU/ml concomitant of a glycaemia under 2.2 mmol/l allows the diagnostic. In the other hand to show the interest of transgastric biopsy during echo-endoscopy when evaluating pancreatic mass. Finally the enucleo-resection with coeliscopy wich reduces the morbidity.

Volume 11

8th European Congress of Endocrinology incorporating the British Endocrine Societies

European Society of Endocrinology 
British Endocrine Societies 

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