Prognosis

Post-surgical

Following successful surgery and if all tumours were excised, most patients with an insulinoma or tumour secreting insulin-like growth factor (IGF)-II are cured of their disease. A small portion of individuals may have re-growth of a partially excised tumour or growth of a metastasis and subsequently require repeat surgery, chronic medical therapy, or directed therapy for malignant disease.[7]

Medically managed insulinoma

The medical options for the management of an insulinoma are limited and not as effective as surgical resection. Of the available medications diazoxide has been the most effective agent, although complications are common.[47][48][49][50]

Inoperable IGF-II-secreting tumours

For the patient with an IGF-II-hypersecreting tumour who is not an operable candidate, there is a strong possibility of becoming refractory to the use of glucagon to support glucose levels. Few studies exist on other alternatives, although oral glucocorticoid administration has worked well in some case studies.[55]

Exposure-related hypoglycaemia

Patients with factitious or drug exposure-induced hypoglycaemia have a favourable outlook. Symptoms should not recur so long as surreptitious use of insulin and offending medications are avoided.

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