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Treatment of Insulinomas: The treatment of insulinomas consists of controlling hypoglycemia by dietary and pharmacologic approaches followed by definitive surgical resection of the tumor.

Diazoxide, a non-diuretic thiazide analog, has potent hyperglycemic effects. It enhances glycogenolysis and inhibits insulin release from beta cells. Another agent that can control hypoglycemia is octreotide - a somatostatin analog. It provides symptom relief and reduces plasma insulin levels by interacting with the high-affinity somatostatin receptors type 2 and 5 on the tumor cells.

mTOR pathway inhibitor everolimus has shown effectiveness in controlling symptoms in metastatic insulinomas refractory to other therapies.

The surgical treatment of insulinomas depends upon size and location of the tumor. It can range from enucleation to subtotal pancreatectomy.

Image courtesy of: Dr. Aatur Singhi (@PancPathologist); used with permission.

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