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Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
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Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

Glucose Homeostasis: Pancreatic Islets and Insulin Secretion

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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.
Insulin and C-peptide are...
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Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

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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.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
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Insulin Secretory Vesicles01:05

Insulin Secretory Vesicles

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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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Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

305
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: The Receptor and Signaling Pathways01:28

Insulin: The Receptor and Signaling Pathways

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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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Related Experiment Video

Updated: Jul 23, 2025

Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
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Ectopic insulinoma: a systematic review.

Fernando Guerrero-Pérez1,2,3, Nuria Vilarrasa4,5,6, Lidia V Huánuco4,5

  • 1Department of Endocrinology, Bellvitge University Hospital, Barcelona, Spain. fguerrerop@bellvitgehospital.cat.

Reviews in Endocrine & Metabolic Disorders
|July 11, 2023
PubMed
Summary

Ectopic insulinomas, rare tumors causing hypoglycemia, predominantly affect women. Advanced imaging like [68Ga]Ga-DOTA-exedin-4 PET/CT is crucial for locating these extra-pancreatic tumors when standard methods fail.

Keywords:
Aberrant insulinomaEctopic insulinomaExtra-pancreatic insulinomaInsulinoma

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Last Updated: Jul 23, 2025

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Area of Science:

  • Endocrinology
  • Oncology
  • Radiology

Background:

  • Ectopic insulinomas are rare neuroendocrine tumors originating outside the pancreas.
  • Knowledge is limited, primarily from case reports, hindering comprehensive understanding.

Purpose of the Study:

  • To systematically review and characterize ectopic insulinomas reported over the last four decades.
  • To evaluate diagnostic imaging modalities and clinical outcomes.

Main Methods:

  • Systematic literature review of PubMed, Web of Science, Embase, eLibrary, and ScienceDirect.
  • Inclusion of one unreported patient case.
  • Analysis of patient demographics, symptoms, tumor characteristics, diagnostic methods, treatment, and outcomes.

Main Results:

  • 28 ectopic insulinoma cases identified; 78.6% female, mean age 55.7 years.
  • Hypoglycemia was the primary symptom (85.7%).
  • High sensitivity of [68Ga]Ga-DOTA-exedin-4 PET/CT and 68Ga-labeled DOTA-conjugated somatostatin analogue PET/TC (100%) for localization.

Conclusions:

  • Ectopic insulinomas present with hypoglycemia and show a female predominance.
  • Functional imaging, particularly PET/CT, is highly effective for tumor localization.
  • Clinicians must consider ectopic insulinomas when pancreatic exploration is unrevealing.