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Insulin: Dosing Regimen and Adverse Effects01:16

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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.
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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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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 is released by beta cells of the pancreas when blood glucose levels are high. It facilitates glucose absorption and utilization in insulin-dependent cells with insulin receptors on their plasma membranes. Insulin promotes glucose uptake by increasing the number of glucose transport proteins in the cell membrane, allowing glucose to enter the cell. As a result, glucose utilization and ATP production are enhanced.
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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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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Updated: Sep 20, 2025

Isolation of Human Islets from Partially Pancreatectomized Patients
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In-Hospital Postoperative Glycemic Trends After Pancreatic Insulinoma Resection.

Sarah Lund1, Sergio Navarro1, Adrian Vella2

  • 1Department of Surgery, Mayo Clinic, Rochester, Minnesota.

The Journal of Surgical Research
|May 28, 2025
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Summary

Most patients experience temporary hyperglycemia after insulinoma surgery, typically resolving within 35 hours. Smaller tumors and younger age predict faster glucose normalization, aiding in-hospital glucose management.

Keywords:
HypoglycemiaInsulinomaPancreatectomy

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Metabolic Disorders

Background:

  • Post-resection hyperglycemia is common after insulinoma removal.
  • Understanding predictors of glucose normalization is crucial for patient management.

Purpose of the Study:

  • To analyze in-hospital glucose trends after insulinoma resection.
  • To identify predictors of early postoperative hyperglycemia normalization.

Main Methods:

  • Retrospective single-center study (2010-2023).
  • Included patients undergoing distal pancreatectomy, enucleation, or ethanol ablation for solitary benign insulinoma.
  • Analyzed postoperative glucose levels and time to normalization.

Main Results:

  • 73% of 117 patients had transient hyperglycemia; 24% had persistent hyperglycemia.
  • Median time to glucose normalization was 35 hours.
  • Smaller insulinoma size (median 1.5 cm) and younger age predicted faster normalization (within 5 days).
  • Older age and male gender were associated with prolonged hyperglycemia.

Conclusions:

  • Transient postoperative hyperglycemia is common but usually resolves quickly after insulinoma resection.
  • Tumor size and patient age are key factors influencing early glucose normalization.
  • Findings help anticipate postoperative glucose trends for better patient care.