Do you often feel dizzy when your blood sugar drops? Could it be due to Insulinoma?

Do you sometimes feel faint, sweaty, blue-eyed, and dizzy ? This could be due to a sudden drop in your blood sugar levels ( hypoglycemia ). This is normal for someone with diabetes , such as if they take too much medication or miss a meal. But if this happens to someone without diabetes all the time, the cause may be something you don't even think about. That's a rare condition that we all need to be aware of, called insulinoma .

What exactly is an insulinoma?

Simply put, an insulinoma is a small, usually non-cancerous tumor that develops in our pancreas . Our pancreas produces a hormone called insulin. The function of this insulin is to control the amount of sugar (glucose) in the blood.

Think about it, normally when our body's sugar levels increase, the pancreas produces insulin. When our sugar levels decrease, it stops producing insulin. It's like a switch that turns on/off at the right time.

But when this tumor called an insulinoma develops, it produces insulin continuously . It's like the switch is stuck in the 'on' position. What happens is that insulin continues to be produced even when our blood sugar levels are very low. This can cause our blood sugar levels to drop dangerously low. Because these tumors are made up of a special type of nerve cell (neuroendocrine cells), your doctor may also call them a ``neuroendocrine tumor''. These tumors are often very small (less than an inch) and are more than 90% non-cancerous. Therefore, they can be completely cured with surgery.

What are the symptoms of this condition?

Because the insulinoma continues to produce insulin, symptoms are caused by low blood sugar levels (hypoglycemia). These symptoms can appear suddenly.

What causes insulinoma? Who is at higher risk?

The exact cause of these tumors has not yet been discovered, but certain factors may increase the risk.

• Women have a slightly higher tendency than men.
• It is most often diagnosed in people between the ages of 40 and 60 .
• People with certain genetic conditions are also at higher risk. For example:
• Multiple endocrine neoplasia type 1: A condition in which tumors form in the hormone-producing glands.
• Von Hippel-Lindau syndrome: A condition in which tumors and tumor-like structures ( cysts ) form in various organs of the body.
• Neurofibromatosis type 1: Noncancerous growths on the nerves and skin.
• Tuberous sclerosis: Non-cancerous tumors in organs such as the brain, eyes, heart, and kidneys.

How does a doctor find this?

Diagnosing insulinoma can be a bit tricky, as the symptoms are similar to those of other common diseases, so it can take a while for your doctor to diagnose it.

The main thing is to do a '72-hour fast' . In this, you are kept in the hospital for two to three days and are not allowed to eat or drink anything except water. During this time, the doctors will regularly check your blood sugar and insulin levels.

They are trying to confirm these three things through this test:

1. Are you experiencing symptoms of low blood sugar (such as dizziness, sweating).

2. When those symptoms appear, is the blood sugar level really low?

3. Will the symptoms go away when you give some sugar (glucose) externally?

If you have an insulinoma, your fasting blood sugar level will be very low, but your insulin level will be high. This is the main evidence. Along with this, blood tests will also look for things like `(C-peptide)` and `(proinsulin)`.

Then, imaging tests are done to find exactly where the pancreatic tumor is located.

• CT scan `(CT scan)`
• Ultrasound scan `(Ultrasound)`
• MRI scan `(MRI)`

What are the treatments for this?

The main and most successful treatment for insulinoma is surgery to remove the tumor . In most cases, the disease is completely cured after surgery.

The type of surgery performed depends on the type, size, and location of the tumor.

• Removing just the tumor: Surgeons can carefully remove just the tumor without damaging the pancreas.
• Removing part of the pancreas: Sometimes a small part of the pancreas that is associated with the tumor also needs to be removed.

With today's advanced technology,These tumors can also be removed through laparoscopic surgery. This means that instead of one large incision, the surgery is performed through several small incisions with the help of a camera. The advantages of this are that it is less painful, the number of days you stay in the hospital is shorter, and you can return to your normal life sooner.

Treatment for cancerous tumors

Very rarely (less than 10%) these tumors can become cancerous. In such cases, treatment varies. If the entire tumor cannot be removed surgically, you may need to take medication to stop the blood sugar from dropping too low. You may also need chemotherapy . For some types of cancer, there are special treatments, such as ``Lutetium Lu 177 dotatate``, which involves giving a radioactive drug through a vein.

Are there any complications after surgery?

Although the surgery is successful in most cases, as with any surgery, there is a risk of minor complications.

• Bleeding
• Infection
• Pain
• If a large part of the pancreas is removed, there is a risk of developing diabetes.
• Leakage of fluid from the pancreas (Pancreatic fistula)
• Decreased digestive enzymes.

If it is a cancerous tumor, complications such as the disease spreading to other organs (metastasis) may occur. Your doctor will explain this to you in detail.