Endocrine Abstracts

Introduction: The incidence of glucose metabolism alterations during the follow-up of surgically treated insulinomas is largely unknown. Our aim was to evaluate the incidence, and the clinical characteristics, of diabetes and prediabetes in this population.

Methods: We retrospectively analyzed the cases diagnosed as insulinomas in a Central Hospital in Portugal in the period between January 1980 and December 2015.

Results: We identified 19 patients, 68% women, with a median age at onset of symptoms of 49 years. Enucleation of the tumor was performed in 4 cases and the remaining 15 were submitted to partial pancreatectomy. In one patient, the surgery did not remove the tumor and so total pancreatectomy was performed. All tumors were solitary, with a median diameter of 1.8 cm. Ten tumors were located at the head of the pancreas, 4 at the body, 4 at the tail and 1 at the uncinate process. The median of follow-up was 48 months, with only 4 patients with a follow-up inferior to 6 months because of loss of follow-up or recent intervention. A total of 9 patients presented glucose metabolism alterations on follow-up. Four patients presented diabetes in the immediate postoperative period, 1 presented diabetes 4 months after surgery, 3 presented diabetes 10–12 years after surgery and 1 patient present prediabetes 54 months after surgery. The mean age at diagnosis of glucose metabolism alterations was 54 years. Regarding treatment, 3 patients were treated with insulin, 3 were with oral antidiabetic drugs, 1 with insulin and oral antidiabetic drugs and 2 with lifestyle interventions. Concerning microvascular and macrovascular complications, only 1 patient presented microalbuminuria.

Conclusion: Glucose metabolism alterations are a frequent complication during the follow-up of insulinomas. Prevention, early diagnosis and treatment of diabetes in patients with surgically treated insulinomas must be a priority during the follow-up of these patients.