The diagnosis of insulinoma is based on the Whipple's triad, which includes blood glucose < 55 mg/dL, symptoms of hypoglycemia that can be neuroglycopenic (visual disturbances, confusion, weakness, seizures, coma) or adrenergic symptoms (sweating, tremors, palpitations, and hyperphagia) and resolution of symptoms after ingestion/infusion of glucose. It is also diagnosed on the basis of radioimmunoassay (RIA) and Immunochemiluminescent assay (ICMA) in the absence of hypoglycemia causing agents e.g. insulin and oral hypoglycemic agents (e.g. sulfonylureas) by insulin level (>6 μU/mL (43 pmol/L by RIA and ≥ 3 μU/mL by ICMA, glucose level of < 2.5mmol/L (55mg/dL) and C-peptide level of ≥ 200 pmol/L and/or proinsulin level ≥ 25% or ≥ 22pmol/L. The gold standard for the diagnosis of insulinoma is 72-hour fasting test.
Insulinoma diagnostic criteria
Insulinoma staging
Insulinoma classification
Insulinoma risk factors
Insulinoma medical therapy
Insulinoma laboratory tests
Insulinoma future or investigational therapies
Glucagonoma epidemiology and demographics