A clinical update on tumor-induced hypoglycemia.
Eur J Endocrinol. 2014 Jan 23;
Authors: Iglesias P, Díez JJ
Abstract
Tumor-induced hypoglycemia is a rare clinical entity that may occur in patients with diverse kinds of tumor lineages and that may be caused by different mechanisms. These pathogenic mechanisms include the eutopic insulin secretion by a pancreatic islet beta-cell tumor, and also the ectopic tumor insulin secretion by non-islet-cell tumor, such as bronchial carcinoids and gastrointestinal stromal tumors. Insulinoma is, by far, the most common tumor associated to clinical and biochemical hypoglycemia. Insulinomas are usually single, small, sporadic and intrapancreatic benign tumors. Only 5-10% of insulinomas are malignant. Insulinoma may be associated to the multiple endocrine neoplasia type 1 in 4-6% of patients. Medical therapy with diazoxide or somatostatin analogs has been used to control hypoglycemic symptoms in patients with insulinoma, but only surgical excision by enucleation or partial pancreatectomy is curative. Other mechanisms that may, more uncommonly, account for tumor-associated hypoglycemia without excess insulin secretion are the tumor secretion of peptides capable of causing glucose consumption by different mechanisms. These are the cases of tumor producing IGF-2 precursors, IGF-1, somatostatin and GLP-1. Tumor autoimmune hypoglycemia is due to the production by tumor cells of insulin or insulin receptor autoantibodies. Lastly, massive tumor burden with glucose consumption, massive tumor liver infiltration and pituitary or adrenal glands destruction by tumor are other mechanisms for tumor-induced hypoglycemia in cases of large and aggressive neoplasias.
PMID: 24459236 [PubMed - as supplied by publisher]
More...
Insulin like growth factors
IGF-1
Igf-1r3
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Eur J Endocrinol. 2014 Jan 23;
Authors: Iglesias P, Díez JJ
Abstract
Tumor-induced hypoglycemia is a rare clinical entity that may occur in patients with diverse kinds of tumor lineages and that may be caused by different mechanisms. These pathogenic mechanisms include the eutopic insulin secretion by a pancreatic islet beta-cell tumor, and also the ectopic tumor insulin secretion by non-islet-cell tumor, such as bronchial carcinoids and gastrointestinal stromal tumors. Insulinoma is, by far, the most common tumor associated to clinical and biochemical hypoglycemia. Insulinomas are usually single, small, sporadic and intrapancreatic benign tumors. Only 5-10% of insulinomas are malignant. Insulinoma may be associated to the multiple endocrine neoplasia type 1 in 4-6% of patients. Medical therapy with diazoxide or somatostatin analogs has been used to control hypoglycemic symptoms in patients with insulinoma, but only surgical excision by enucleation or partial pancreatectomy is curative. Other mechanisms that may, more uncommonly, account for tumor-associated hypoglycemia without excess insulin secretion are the tumor secretion of peptides capable of causing glucose consumption by different mechanisms. These are the cases of tumor producing IGF-2 precursors, IGF-1, somatostatin and GLP-1. Tumor autoimmune hypoglycemia is due to the production by tumor cells of insulin or insulin receptor autoantibodies. Lastly, massive tumor burden with glucose consumption, massive tumor liver infiltration and pituitary or adrenal glands destruction by tumor are other mechanisms for tumor-induced hypoglycemia in cases of large and aggressive neoplasias.
PMID: 24459236 [PubMed - as supplied by publisher]
More...
Insulin like growth factors
IGF-1
Igf-1r3
This has been a World Class Bodybuilding automated thread
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