Some cardohydrate metabolism parameters in the patients prior to and after removal of insulinoma

Abstract

Measurements of the daily fluctuations in the sugar blood levels, fasting test, the double glucose tolerance test, and measurements of the blood insulin and C peptide levels were carried out in 13 patients with organic hyperinsulinism prior to insulinoma removal and in the immediate and late periods after it. The double glucose tolerance test was for the first time used to study carbohydrate metabolism in patients with organic hyperinsulinism. The curve of this test in insulinoma patients was found to resemble that in health, though with lower levels and a more abrupt lowering of its end section. This feature may be used to define the origin of hyper insulinism. No correlation between the blood glucose, insulin, and C peptide levels was detectable before surgery in this patient population. After surgery the imbalance in these three parameters relationships is eliminated. Carbohydrate metabolism parameters normalized after the operation; the lowest blood sugar level was increased twofold in the fasting test. Transitory hyperglycemia persisted for two weeks after elimination of hyperinsulinism. Daily fluctuations in the blood sugar levels normalize during the third week after surgery.