Using Continuous Glucose Monitoring for Patients with Insulinoma

  • J. F. Han
  • Y. BaoEmail author


Insulinoma is a tumor mainly made up of specialized pancreatic islet β-cells, and it is characterized by recurrent fasting hypoglycemia. Because hypoglycemic events usually occur during night or in the early morning and different individuals have different plasma glucose thresholds for hypoglycemic symptoms, early detection of insulinoma is often difficult. Continuous glucose monitoring (CGM) techniques can be used to monitor the blood glucose variation and to identify hypoglycemia, especially nocturnal hypoglycemia, which cannot be detected by self-monitoring blood glucose (SMBG). In-depth analyses of the time distribution, type, and pattern of hypoglycemia, especially in combination with fasting test, facilitate the diagnosis of insulinoma. Moreover, CGM helps to develop a comprehensive understanding of postoperative blood glucose changes as well as to accurately assess surgical efficacy in patients with insulinoma.


Insulinoma Hypoglycemia Continuous glucose monitoring Fasting test 


  1. 1.
    Calledder GG, Rich TA, Perrier ND. Multiple endocrine neoplasia syndromes. Surg Clin North Am. 2008;88:863–95. Scholar
  2. 2.
    Muro S, Nasu J, Harada R, Matsubara M, Nakarai A, Kanzaki H, Tsutsumi K, Kato H, Tanaka T, Fujiwara H, Uno M, Okada H, Yamamoto K. Prompt resolution of hypoglycemia by hepatic transarterial embolization for malignant insulinoma with multiple liver metastases. Acta Med Okayama. 2014;68:303–6. Scholar
  3. 3.
    Varas M, Gornals J, Ponseti JM, Alastruè A, Durán C, Llevaria C, Ballesta C, Díez-Caballero A, Artigas V. Pancreatic endocrine tumors or apudomas. Rev Esp Enferm Dig. 2011;103:184–90.CrossRefPubMedGoogle Scholar
  4. 4.
    Grant CS. Insulinoma. Best Pract Res Clin Gastroenterol. 2005;19:783–98. Scholar
  5. 5.
    Ito T, Igarashi H, Jensen RT. Pancreatic neuroendocrine tumors: clinical features, diagnosis and medical treatment: advances. Best Pract Res Clin Gastroenterol. 2012;26:737–53. Scholar
  6. 6.
    Han JF, Zhang F, Bao YQ, Zhou J, Lu W, Lu JX, Jia WP. Diagnostic value of parameters of glucose metabolism as screening tests for insulinoma. Zhonghua Yi Xue Za Zhi. 2010;90:1093–6. Scholar
  7. 7.
    Vaidakis D, Karoubalis J, Pappa T, Piaditis G, Zografos GN. Pancreatic insulinoma: current issues and trends. Hepatobiliary Pancreat Dis Int. 2010;9:234–41.PubMedGoogle Scholar
  8. 8.
    Patel S, Narwari M, Parekh D, Shah V. Insulinoma: case report and review of diagnostic and treatment modalities. J Assoc Physicians India. 2013;61:423–6.PubMedGoogle Scholar
  9. 9.
    Anakal MG, Kalra P, Dharmalingam M, Indushekhar S, Rao V, Prasanna Kumar KM. Insulinoma case series: experience of a tertiary care center. Indian J Endocrinol Metab. 2014;18:858–62. Scholar
  10. 10.
    Han JF, Zhang F, Bao YQ, Zhou J, Lu W, Lu JX, Zhao JG, Huang XY, Bao ZK, Hu B, Jia WP. A case with insulinoma localized by combined use of various means. Chin Med J. 2011;124:476–9.PubMedGoogle Scholar
  11. 11.
    Monsod TP, Flanagan DE, Rife F, Saenz R, Caprio S, Sherwin RS, Tamborlane WV. Do sensor glucose levels accurately predict plasma glucose concentrations during hypoglycemia and hyperinsulinemia? Diabetes Care. 2002;25:889–93.CrossRefPubMedGoogle Scholar
  12. 12.
    Caplin NJ, O’Leary P, Bulsara M, Davis EA, Jones TW. Subcutaneous glucose sensor values closely parallel blood glucose during insulin-induced hypoglycaemia. Diabet Med. 2003;20:238–41. Scholar
  13. 13.
    Wang X. Application of the continuous glucose monitoring system (CGMS) in the 72-hour fast test in two patients with hypoglycemia. Diabetes Technol Ther. 2004;6:883. Scholar
  14. 14.
    Zhou J, Jia WP, Bao YQ, Lu W, Ma XJ, Yu M, Pan JM, Hu C, Xiang KS. Characteristics and clinical significance of daily blood glucose profiles of insulinoma detected by continuous glucose monitoring system. J Shanghai Jiaotong Univ (Med Sci). 2007;27:781–4. Scholar
  15. 15.
    Munir A, Choudhary P, Harrison B, Heller S, Newell-Price J. Continuous glucose monitoring in patients with insulinoma. Clin Endocrinol. 2008;68:912–8. Scholar
  16. 16.
    Cheyne EH, Cavan DA, Kerr D. Performance of a continuous glucose monitoring system during controlled hypoglycaemia in healthy volunteers. Diabetes Technol Ther. 2002;4:607–13. Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. and Shanghai Scientific and Technical Publishers 2018

Authors and Affiliations

  1. 1.Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Diabetes InstituteShanghai Jiao Tong University, Affiliated Sixth People’s HospitalShanghaiChina

Personalised recommendations