Ways to control hypoglycemia caused by insulinoma in pancreas?

Posted by pontiac @pontiac, Mar 26, 2023

Anyone had Whipple, still unable to control hypoglycemia. There's only so much food I can eat, and I've gained too much weight trying to control it. My glucose can drop 60 points in 15 to 20 minutes

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@beth71

The hardest part was finding a facility (in the south) and an Interventional Radiologist who performs enough cases to remain competent in the procedure. The next most challenging aspect was the NPO status. I was allowed to have Clear liquids up to 2 hrs. prior to arrival for blood glucose rescue if needed. Labs drawn and Iv started prior to case. Once in Procedure Room, I was sedated, IV conscious sedation so no intubation. They accessed my Right Femoral vein and artery (Right groin area). Imaging was then used to get to the vessels that perfuse the pancreas. At each artery, they injected Calcium and then true multiple timed blood draws on he venous side looking for increasing trends in Insulin levels. When they injected the calcium, I could feel it going through my upper abdomen, It was a weird sensation. During the procedure, LOTS of blood samples are taken in the range of 70-80. Once completed, an Angio-seal with dressing was used and had to lie flat for 2 hrs. before discharge. Once we got back to the hotel, I went straight to the bathroom to find that I was bleeding from the site with a saturated dressing. I immediately grabbed a washcloth and applied pressure and we immediately went to the ED. Thankfully it was my venous access that was oozing, but had pretty much resolved upon arrival to ED. The Int Rad Team came to evaluate me and re-dress my site and we went back to hotel. That was the only hiccup I encountered. I am on high dose steroids daily so my bruising in the area was significant, but no adverse complications. Some of the labs drawn for test analysis were send-outs so waiting almost 3 weeks for the results was a bit challenging. Best wishes for a successful procedure, answers and a reasonable plan of care.

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Beth where did you go for the procedure and who was your radiologist? Thanks so much.

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Corn starch will help stabilize your suger

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@lastround

Corn starch will help stabilize your suger

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Diazoxide is only med prescribed to help hypoglycemia caused by endocrine tumors. If cornstarch worked they would have diabetics use it in low circumstances. The issue with endocrine tumors is insulin is being dumped by pancreas all the time even when not eating into system. Consequently liver never releases glycogen except when you eat to raise blood sugar. Because normally insulin release tells liver blood sugar is high don't release any glycogen to raise it.

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I didn’t have a whipped but have a pancreatic tumor and numerous liver tumors. I also have no feelings of hunger so would often forget to eat . My solution was nutritional drinks that I drink on a schedule. I usually try to eat something with it . My weight has maintained and I no longer deal with the sudden feeling of low blood sugar. Hope this helps and that you find a solution that works for you !

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@pontiac

Diazoxide is only med prescribed to help hypoglycemia caused by endocrine tumors. If cornstarch worked they would have diabetics use it in low circumstances. The issue with endocrine tumors is insulin is being dumped by pancreas all the time even when not eating into system. Consequently liver never releases glycogen except when you eat to raise blood sugar. Because normally insulin release tells liver blood sugar is high don't release any glycogen to raise it.

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I have stage 4 NET pancreatitis to liver cancer. Also had trouble with sugar levels dropping dramatically. The doctors at Dane Farber in Boston recommended Corn Starch and it helped.
Not claiming that Corn Starch is the cure, but it helped to stabilize my sugars so it could be managed until liver tumors could be reduced.
It may not work for everyone, it definitely doesn’t work if you don’t try.
I mixed it with pudding and it was tasteless.

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For me my sugar would drop in teens, constant glucose monitor are a must for safety. My levels get so low I pass out . Sleeping was impossible. Dropping low enough to pass out is horrible feeling. Food did not impact mine. Every neuroendocrine tumor patient is different. But if you can't sleep because of it the diazoxide is a life saver. It's given me back some quality of life. I still do not drive after totalling my truck a year ago. My one piece of advice do not wait, be your own advocate and push for treatment. There are plenty of treatment options. Endocrinologist are experts with functioning neuroendocrine tumors that are disrupting the endocrine system, regular MDs are not qualified.

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@pontiac

For me my sugar would drop in teens, constant glucose monitor are a must for safety. My levels get so low I pass out . Sleeping was impossible. Dropping low enough to pass out is horrible feeling. Food did not impact mine. Every neuroendocrine tumor patient is different. But if you can't sleep because of it the diazoxide is a life saver. It's given me back some quality of life. I still do not drive after totalling my truck a year ago. My one piece of advice do not wait, be your own advocate and push for treatment. There are plenty of treatment options. Endocrinologist are experts with functioning neuroendocrine tumors that are disrupting the endocrine system, regular MDs are not qualified.

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They tried the diazoxide on my husband but he had a bad reaction so ended up on once monthly octreotide along with his other chemo treatments. You are right, everyone has a different reaction to treatment and because of the rarity of metastatic insulinoma it is important to find a good oncology/endrocrinology team. Wishing you the best.

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My husband is currently undergoing PRRT treatment. Wondering if any of you have had this treatment and your experiences with this?

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@bnjncrew

My husband is currently undergoing PRRT treatment. Wondering if any of you have had this treatment and your experiences with this?

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I'm currently doing the lutathera treatment that includes sandostatin shot the day after. I've done 2 so far with 2 left. Only side effects I've had is really tired after. Now the sandostatin shots I've had low blood sugar events a couple days after. Currently now my blood sugar has changed to being high, whether that's a response to treatment or caused by higher dose of diazoxide I'm currently doing is unclear. Be prepared for full day the day you receive the lutathera. Hope this helps.

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@bnjncrew

My husband is currently undergoing PRRT treatment. Wondering if any of you have had this treatment and your experiences with this?

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Hello @bnjncrew

I hope that your husband is doing well with his PRRT treatments. We have a few discussions on this topic which you might find helpful. Here are the links

--Interested in Hearing Other Peoples' Experiences with PRRT.
https://connect.mayoclinic.org/discussion/prrt-treatment/
--Questions about Blood Test Results After PRRT Treatment
https://connect.mayoclinic.org/discussion/post-prrt-blood-tests/
Please feel free to read the posts in these discussions and ask questions of the members. Many have had good experiences with PRRT and will be happy to share with you.

When was your husband's first treatment? How is he feeling? Any side-effects that were unexpected?

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