Faculty Collaboration Database

Incidence and management of postoperative hyperglycemia in patients undergoing insulinoma resection. Endocrine 2018 Sep;61(3):422-427

Date

06/21/2018

Pubmed ID

29923016

Pubmed Central ID

PMC8058619

DOI

10.1007/s12020-018-1633-1

Scopus ID

2-s2.0-85048812081 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

PURPOSE: It has been proposed that rebound hyperglycemia after resection of insulinoma indicates a biochemical cure. However, there is scant objective data in the literature on the rate and need for intervention in hyperglycemia in patients undergoing resection of insulinoma. The goal of our study was to evaluate the rate of postoperative hyperglycemia, any predisposing factors, and the need for intervention in a prospective cohort study of all patients undergoing routine glucose monitoring.

METHODS: A retrospective analysis of 33 patients who had an insulinoma resected and who underwent routine postoperative monitoring of blood glucose (every hour for the first six hours then every four hours for the first 24 h) was performed. Hyperglycemia was defined as glucose greater than 180 mg/dL (10 mmol/l).

RESULTS: Twelve patients (36%) developed hyperglycemia within 24 h (range 1-16 h). In patients with hyperglycemia, the mean maximum plasma glucose level was 221.5 mg/dL (range 97-325 mg/dL) (12.3 mmol/l), and four (33%) patients were treated with insulin. There was no significant difference in age, gender, body mass index (BMI), tumor size, biochemical profile, or surgical approach and extent of pancreatectomy between patients who developed hyperglycemia and those who did not. Pre-excision and post-excision intraoperative insulin levels were evaluated in 14 of 33 patients. The percentage decrease of the intraoperative insulin levels was not significantly different between patients who developed hyperglycemia and those who did not. All patients with postoperative hyperglycemia had normalization of their glucose levels, and none were discharged on anti-hyperglycemic agents.

CONCLUSIONS: Hyperglycemia is common after insulinoma resection, and a subset of patients require transient treatment with insulin.

Author List

Nockel P, Tirosh A, El Lakis M, Gaitanidis A, Merkel R, Patel D, Nilubol N, Sadowski SM, Cochran C, Gorden P, Kebebew E

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Blood Glucose
Digestive System Surgical Procedures
Female
Humans
Hyperglycemia
Hypoglycemic Agents
Incidence
Insulin
Insulinoma
Male
Middle Aged
Pancreatic Neoplasms
Postoperative Complications
Postoperative Period
Retrospective Studies