The pancreas is an organ in the abdomen. The pancreas makes several enzymes and hormones, including the hormone insulin. Insulin's job is to reduce the level of sugar (glucose) in the blood by helping it move into cells.
Most of the time when your blood sugar level drops too low, the pancreas stops making insulin until your blood sugar returns to normal. Tumors of the pancreas that produce too much insulin are called insulinomas. Insulinomas keep making insulin, even when your blood sugar drops too low.
A high blood insulin level causes a low blood sugar level (hypoglycemia). Hypoglycemia may be mild, leading to symptoms such as anxiety and hunger. Or it can be severe, leading to seizures, coma, and even death.
Insulinomas are rare tumors. They usually occur as single, small tumors in adults.
These tumors are very rare in children. Most children with high blood insulin levels have many areas of overactive insulin-releasing cells in the pancreas, instead of a single tumor.
Surgery is the recommended treatment for insulinoma. The tumor is first found by tests or surgery. Medication may be used to get patients stable before surgery.
If there is a single tumor, it will be removed. If there are many tumors, part of the pancreas will need to be removed (partial pancreatectomy). At least 15% of the pancreas must be left to produce its enzymes for digestion. This may prevent the surgeon from removing the whole insulinoma tumor.
In rare cases, the entire pancreas is removed if there are many insulinomas or they continue to come back. Removing the entire pancreas leads to diabetes because there is no longer any insulin being produced. Insulin injections are then required.
If no tumor is found during surgery, or if you are not a candidate for surgery, you may get the drug diazoxide to lower insulin production and prevent hypoglycemia. A diuretic (water pill) is given with this medication to prevent the body from retaining fluid. Octreotide is used to reduce insulin release in some patients.