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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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Insulin Secretory Vesicles01:05

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Insulin secretory vesicles release insulin to stimulate blood glucose uptake and regulate carbohydrate metabolism. When the blood glucose levels increase, glucose enters the pancreatic β-islet cells through glucose transporters. Once inside, glucose is metabolized through glycolysis, the citric acid cycle, and the electron transport chain, producing ATP. This increase in ATP concentration closes ATP-sensitive potassium channels, leading to depolarization of the membrane and the opening of...
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Insulin: The Receptor and Signaling Pathways01:28

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Insulin action is mediated through a receptor tyrosine kinase, akin to the IGF-1 receptor. The number of receptors per cell varies significantly, from 40 on erythrocytes to 300,000 on adipocytes and hepatocytes. The insulin receptor consists of linked α/β subunit dimers, forming a heterotetramer glycoprotein with two extracellular α subunits and two β subunits spanning the membrane. The α subunits inhibit the inherent tyrosine kinase activity of the β subunits, but...
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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

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The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
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Hypoglycemia and Glucagon01:15

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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Insulin: Biosynthesis, Chemistry, and Preparation01:25

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The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
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Updated: Jan 6, 2026

Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
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[Malignant insulinoma].

E A Troshina1, M Y Yukina1, A V Egorov2

  • 1Endocrinology Research Centre.

Problemy Endokrinologii
|October 2, 2019
PubMed
Summary
This summary is machine-generated.

Malignant insulinomas are rare, but this case highlights a young woman with a pancreatic neuroendocrine tumor causing hyperinsulinism and liver metastases. Early diagnosis and treatment are crucial for managing this aggressive condition.

Keywords:
hypoglycemic syndromemalignant insulinoma

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Area of Science:

  • Endocrinology
  • Oncology
  • Gastroenterology

Background:

  • Malignant insulinomas are rare, comprising a small subset of gastroenteropathic endocrine neoplasms.
  • Most insulinomas are benign; however, malignant variants present significant diagnostic and therapeutic challenges.

Observation:

  • A clinical case of a 28-year-old woman with a malignant insulin-producing neuroendocrine tumor of the pancreas tail is presented.
  • The patient exhibited organic hyperinsulinism and multiple liver metastases, indicating advanced disease.

Findings:

  • Comprehensive examination at the Endocrinological Research Centre provided detailed laboratory diagnostic data and evaluation.
  • Surgical treatment was successfully performed at the N.N. Burdenko Facultative Surgery Clinic.

Implications:

  • This case underscores the importance of considering malignant insulinoma in young patients with unexplained hyperinsulinism and metastatic disease.
  • Effective post-operative management and long-term follow-up are critical for improving patient outcomes in such rare oncological conditions.