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Tumour-induced hypoglycaemia : a narrative review
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Barber, Thomas M., Bannon, Christopher, Weickert, Martin O., Kyrou, Ioannis and Randeva, Harpal S. (2021) Tumour-induced hypoglycaemia : a narrative review. Journal of Laboratory and Precision Medicine, 6 . 22. doi:10.21037/jlpm-20-110
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Official URL: https://doi.org/10.21037/jlpm-20-110
Abstract
Objective: To provide an overview of the pathogenesis and clinical features of tumour-induced hypoglycaemia (TIH), its effective diagnostic work-up and management strategies and the challenges involved.
Background: Hypoglycaemia, defined by a plasma blood glucose level <3.0 mmol/L (<54 mg/dL), results from failure of glucose homeostasis. Although multiple scenarios contribute to the onset of hypoglycaemia, certain tumours represent an important, although relatively uncommon group of causative factors. In patients with unexplained hypoglycaemia, it is important to conduct a careful clinical assessment, with detailed investigations to ascertain the underlying cause(s), and initiate appropriate and effective therapies.
TIH often presents a clinical challenge for both accurate and timely diagnosis and effective management.
Methods: We performed a narrative literature review using PubMed and search-term “Tumour-Induced Hypoglycaemia”, with articles written in English.
Conclusions: There are two main groups of TIH: insulinoma and non-islet cell tumours (NICTs). Insulinomas are the commonest form of pancreatic neuroendocrine tumour, and a well-recognised cause
of hyperinsulinaemia associated with recurrent hypoglycaemia. Conversely, NICTs mediate hypoglycaemia through the excessive production of big insulin-like growth factor 2 (IGF2), that cross-reacts with the insulin receptor. Through careful biochemical assessment, accurate diagnosis of Insulinoma versus NICTs provides a rationale for effective and individually tailored management.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Hypoglycemia, Islands of Langerhans -- Tumors | ||||||
| Journal or Publication Title: | Journal of Laboratory and Precision Medicine | ||||||
| Publisher: | AME Publishing Company | ||||||
| ISSN: | 2519-9005 | ||||||
| Official Date: | 30 July 2021 | ||||||
| Dates: |
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| Volume: | 6 | ||||||
| Article Number: | 22 | ||||||
| DOI: | 10.21037/jlpm-20-110 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||
| Copyright Holders: | © Journal of Laboratory and Precision Medicine. All rights reserved | ||||||
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