I vawt, i thawmhnaw hak, leh luak chhuak nghal maiin i inhria em? Insulinoma a ni thei! Hemi chungchang hi han sawi ila.

I thisen sugar a tlak hniam lai ang chiah khan luak chhuak nghal mai, lu hah, leh rilru na tak tak i tawng tawh em? A châng chuan heng thilte hi i riltam vang mai maiah i ngai a, mahse a tlem berah chuan, hei hi chhan dang a awm thei. Vawiin hian kan sawi dawn a, thil awm lo tak, mahse hriat tur pawimawh tak kan sawi dawn a ni. Chu chu insulinoma an tih condition a ni.

He insulinoma hi eng nge ni?

A awlsam zawngin, insulinoma chu kan pancreas-a lo awm, cancer ni lo, tumor te tak te a ni. Tunah chuan he pancreas hi eng nge a nih i ngaihtuah mai thei. Pancreas hi kan pum chhungah, kan pum hnung lamah awm, taksa peng te tak te, mahse pawimawh tak a ni. Kan ei leh in kan chawm thei tur enzyme a siam a, chubakah insulin an tih hormone a siam bawk a, chu chuan kan thisen sugar level a control a ni.

Chuvangin, he insulinoma hi a lo awm chuan kan thisenah insulin a chhuah tur aia tam a tichhuak thin. Tui tap khar, a leak reng ang mai a ni.

Heng insulinomas te hi neuroendocrine tumor chi khat, pancreas-a lo awm, Pancreatic Neuroendocrine Tumors (pNETs) an tih a ni. Hengte hi tumor awm lo tak tak an ni. A tha ber chu heng insulinomas zinga 85% atanga 90% vel hi nonmetastatic/indolent an ni. Chumi awmzia chu pancreas pawn lama taksa peng dangah an darh lo tihna a ni. Mahse, a tlem hle a, metastatic/aggressive an ni thei. An tih chuan a bul hnaia lymph node leh liver-ah te an darh tam ber.

Engtin nge insulinoma hian taksa a nghawng?

A hmain ka sawi tawh ang khan insulinoma hi tumor a ni a, insulin a siam tam lutuk a ni. Chuti a nih chuan, insulin a tam lutuk chuan eng nge thleng? Insulin hnathawh ber chu thisena sugar (glucose kan ti bawk) chu cell-ah a hruai lut a ni. Tichuan cell te hian chakna an hmu ta a ni. Mahse insulin a tam lutuk chuan thisen a sugar awm zat chu a tlahniam nghal a ni. Hetiang dinhmun hi hypoglycemia kan ti a ni . Sinhala tawngin thisen thlum tlahniam tihna a ni.

Hetianga i thisen sugar a tlahniam chuan symptoms i nei tan thin.

Ngaihtuah teh, chawhmeh i ei tawh a, office-ah i kal tawh a, hna i thawk tawh bawk. Vawikhatmah i na a, i thawmhnaw a hah a, i lu a hah a, i lu a hah bawk. I chau leh riltam ang mai a ni.

Hetiang hunah hian rang taka thil thlum tak tak, apple tui tlem te, sugar nena tea no khat emaw, banana emaw ang chi i ei emaw, i in emaw chuan rei vak lo hnuah i rilru a hahdam tan ang.

Mahse, hetianga thisen sugar hniam neih hi, a bik takin a chhan hre lo leh engtikah nge a lo awm leh dawn tih hriat loh hi a hlauhawm tak zet a ni. Chuvangin, snack te tak te, toffee ang chi hi a bulah dah reng a tha. Tin, hetiang thil i tawn tawh chuan a rang thei ang bera doctor pan la, hrilh rawh.

Hei hi eng symptoms nge ni?

Insulinoma chhinchhiahna ber chu kan sawi tawh ang khan thisen sugar tlahniam (hypoglycemia) hi a ni. Hei hian symptom chi hrang hrang a thlen thei a ni.

A lan chhuah dan tlangpui:

Hengte hi i hriat hmasak ber tur chu a ni:

• Buaina emaw, ngaihtuahna seng harsa emaw: I lu a inher ang maiin i thil tih laiah i rilru i pe thei lo.
• Thawmhnaw: Thawmhnaw hak mai mai, thawmhnaw lum tak pawh a ni mai thei.
• Heart palpitations: I thinlung thawk ri hriat theih ang maiin i inhria.
• Lungkhamna emaw, thinrimna emaw: Nervous state mai, thinrim awlsam tak.
• Tremors: I ke ruhte chu a nghing ang maiin i hria.
• riltam hlein ka hria.

A lan chhuah dan na tak tak:

I thisen sugar level a tlahniam lutuk chuan i natna chu a na zual thei hle. Symptoms i nei thei ang:

• Vision a inthlak: Vision a blurry a, thil pahnih vawi khata hmuh ang mai a ni.
• Thusawi harsatna: thumal sawi thiam loh, chiang taka sawi theih lohna.
• Balance emaw coordination emaw hloh: Kal laiin staggering, thil pakhat kut phar laiin hma leh hnung lama inthlak.
• Seizures: Fit ang maiin a lo thleng thei.
• Thil hriatna hloh: I muhil thei a, i tlu thei bawk.

A tam zawkah chuan insulinoma vei te hian he thisen sugar tlahniam hi zing lamah an tawng thin a, chu chu zanriah ei khama darkar engemaw zat chaw nghei hnua an harh hnuah a ni. Hei hi ``fasting hypoglycemia'' kan ti a. Mahse, mi thenkhat chuan he thisen sugar hniam hi an ei hnu rei vak lovah pawh an tawng thei a ni.

Hei hi a pawimawh hle: Thisen sugar level hniam zel hian nitin hnathawh a tibuai thei a, a chang chuan thluak a tichhe thei a, coma a thlen thei a, thihna thlengin a thlen thei bawk. Chuvangin, thisen sugar tlahniam symptom i neih chuan doctor pan ngei ngei tur a ni.

Engvangin nge he insulinoma hi a lo awm?

Dik tak chuan, zirchiangtute chuan engvangin nge pancreas-a insulin siamtu cell-te chu thunun theih lohvin an inthen darh a, an pung nghal a, he tumor hi an siam tih chiang takin an la hre chiang lo.

Mahse thil pakhat hmuhchhuah a ni ta. Chu chu, he natna insulinoma an tih hi Multiple Endocrine Neoplasia type 1, emaw (MEN1) an ti \hin tihna a ni.Tin, rochun natna (hereditary condition) insulinoma an tih nen pawh a inzawm thei bawk. Hei hi kan taksaa hormone siamtu gland engemaw zat (entir nan, pituitary gland, parathyroid gland, pancreas)-a tumor a lo awm hian a ni. Insulinomas zawng zawng hi MEN1 avanga lo awm vek a ni lo va, mahse insulinoma zawng zawng zinga 5% atanga 10% vel chu MEN1 vang a ni.

I chhungte, i nu, i pa, emaw, i unaute emaw chu doctor-te’n he natna (MEN1) an nei tih an hrilh a nih chuan, i doctor nen genetic testing chungchang i sawi tur a ni Hei hian he natna hi i nei em tih hriat nan a pui thei che a ni. (MEN1) i neih chuan heng test te hian heng tumor te hi an lo awm hmaa hriat theih nan a pui thei bawk.

Engtin nge doctor-te hian hei hi an hriat chhuah?

Doctor i pan hunah i natna lan chhuah dan an zawt ang che a, an enfiah ang che. Insulinoma i neih thu hriat theihna tur chhinchhiahna lian pathum a awm. Hengte hi Whipple-a triad kan ti a ni.

Anni chu:

1. Thisen thlum tlahniam symptoms neih (a hmaa kan sawi tawh ang khan luak chhuak leh thawk hah ang chi) .

2. Thisen sugar level a hniam tih finfiahna test. (A tlangpuiin finger prick test-ah chuan thisen sugar level 55 mg/dL aia tlem a ni)

3. Sugar (carbohydrates) awmna thil i ei emaw i in emaw hian symptoms a tha zawk.

Heng symptom pathumte hi i neih vek chuan i doctor chuan insulinoma a ringhlel mai thei. Chumi hnuah chuan a diagnosis tih finfiah nan test tlemte dang a order leh ang.

Darkar 72 chhung fast test a ni

Hei hi insulinoma test ber, "gold-standard" a ni. Darkar 72 thleng chaw nghei a ngai a ni. Mahse lungngai suh, hei hi damdawi inah, doctor emaw nurse emaw enkawlna hnuaiah tih a ni. Nangmah chauh i ni lo.

Hetianga chaw i nghei hian i thisen sugar level a tlahniam a, symptoms i nei tan a, doctor-te chuan thisen sample an la ang che a, a hnuaia mite hi an test ang:

• Thisen sugar level a ni
• Insulin level a ni
• Proinsulin level a ni
• C-peptide level a ni
• Beta-hydroxybutyrate level a ni
• Sulfonylurea level (hei hi thisenah zunthlum enkawlna atana hman damdawi thenkhat a awm leh awm loh enfiah nan hman a ni) .

Thisen i ei zawh chuan doctor ten i thisen sugar hniam chu an enkawl ang. Heng test result te hian i thisen sugar tlahniam hi insulin tam lutuk vang a ni em tih hriat nan a pui thei a ni (hei hi hyperinsulinemia kan ti a ni).

Eng test dang nge tih thin? (Imaging test te) 1.1.

Darkar 72 chhung chaw nghei test-naah insulinoma a awm tih a hriat chuan a dawt leh tur chu pancreas-a tumor awmna leh a lian zia hriat a ni. Hei hian a hnuaia scan pakhat emaw a aia tam emaw a huam thei a ni:

• CT scan a ni
• MRI scan a ni
• Pum chhunga ultrasound scan hmanga enfiah a ni
• Endoscopic ultrasound (EUS): Hei hian camera te tak te hmangin tube chu ka chhungah dahin pancreas chhungah en a ni.

Heng scan te hian tumor awmna hmun dik tak a hriat theih loh chuan i doctor chuan specialized test dang, selective arterial calcium stimulation test tih chu a order thei ang. Hei hi test buaithlak zawk a ni.

Hei hi eng enkawl dan nge ni ang?

Thu lawmawm tak chu insulinoma tam zawk hi operation hmanga tihdam vek theih a ni a, a bik takin tumor hi hmun dangah a darh lo (nonmetastatic) a nih chuan.

A bulpui ber chu surgery a ni.

Surgery chi hrang hrang a awm a. I doctor chuan i tumor chi hrang hrang, a awmna hmun leh a lian zawng a zirin eng surgery nge i tan a dik tih a rel ang.

• Enucleation: Hei hian pancreas tichhe nasa lovin tumor chauh lakchhuah a huam a, chu chu uluk taka egg hmin atanga yolk chauh lakchhuah ang chi a ni.
• Partial pancreatectomy: A hming ang bawkin hei hian tumor awmna pancreas hmun thenkhat chu tan chhuah leh lakchhuah a ni.
• Whipple surgery: Hei hi surgery lian tak a ni. Tumor a darh (metastatic) hunah tih thin a ni. Pancreas thenkhat leh a bula tissue thenkhat lakchhuah a ni.

Surgery apiang hian risk engemaw zat a nei vek. I doctor chuan a hrilhfiah vek ang che.

Surgery hma leh surgery a theih loh chuan thisen sugar hniam control dan?

Surgery neih hma emaw, eng emaw vanga surgery tih theih loh a nih chuan i thisen sugar hniam control hi a pawimawh hle.

• I thisen sugar level enfiah fo ang che: I doctor chuan Continuous Glucose Monitoring (CGM) system hmang turin a rawt mai thei . Hei hian i thisen sugar level enfiah chhunzawm zel turin a pui thei che a ni. Hei hian thisen sugar level hniam chu a hmain a hriat theih nan a pui thei a, a bik takin zan lamah.

Mahse hre reng ang che, he `(CGM)` hi insulinoma ang chi dinhmun hriatchhuah nan hman a ni lo va, natna hi a finfiah hnuah enfiah nan hman a ni zawk.

• Ei leh in thlak danglam: A hun taka ei tur ei hian, a bik takin complex carbohydrates (e.g., whole-grain bread, brown rice, thlai chi hrang hrang) ei hian thisen sugar tlahniam nghal lo turin a pui thei a ni. Mut hmaa chawhmeh tlemte ei hian mi thenkhat a pui thei bawk.
• Intravenous glucose (IV glucose): Thisen sugar tlahniam nasa tak i neih chuan damdawi inah saline hmangin glucose pek i ni thei.
• Damdawi chi hrang hrang: 1.1.
• Diazoxide: He damdawi hian pancreas atanga insulin chhuak chu a control thei a ni. Tin, liver atanga glucagon (thisen sugar level tisangtu) chhuahna a tipung thei bawk.
• Octreotide leh Lanreotide: Heng damdawi te hian insulinoma thenkhat atanga insulin chhuak tihtlem nan a pui bawk.

Thisen sugar tlahniam i nei tih ziakna medical identification card keng reng a pawimawh hle. Chutiang chuan harsatna i tawh thut chuan tu emaw chuan a puih vat thei che a ni. Tin, i chhungte leh i thiante chu he thil chungchang leh an tanpui theih dan tur hriattir bawk ang che.

Tumor chu a darh (metastatic) a nih chuan engtin nge tih ang?

A tlem hle a, insulinoma hi taksa hmun dangah a darh tawh (metastatic) a nih chuan doctor-te chuan surgery leh enkawlna dang an hmang dun thei a ni. A nih loh leh, operation tih theih loh chuan he damdawi hi hman theih a ni.

• Peptide Receptor Radionuclide hmanga enkawlna (PRRT) hmanga enkawl a ni.
• Targeted therapy hmanga enkawlna
• Chemotherapy hmanga enkawl a ni

Hengte hi enkawlna chi hrang hrang a buaithlak deuh a, i doctor chuan a hrilhfiah ang che.

Hei hi tihdam theih a ni em?

Awle! Insulinoma hi operation hmangin a dam kim thei fo. Zirchianna pakhatah chuan nonmetastatic insulinoma vanga operation nei zinga 87% chu an hmuhchhuah atanga kum 10 hnuah pawh an la dam tih a tarlang. Chu chu rate tha tak a ni tak zet.

Mahse, tumor hi a darh (metastatic) a nih chuan kum 10 chhunga damchhuah zat chu 33% vel a ni an ti. Mahse, hengte hi general estimate mai a ni tih hre reng ang che. I dinhmun azirin i medical team chuan thu dik zawk an pe thei che a ni.

"Tumor" tih thumal hian min ti hlauthawng thei tih chu a dik a ni. A bik takin insulinoma ang chi natna hlauhawm tak a nih chuan. Mahse a tha ber chu heng zinga a tam zawk hi operation hmanga enkawl theih a ni. Chuti chung pawh chuan, operation ngai, natna hmuh tur awm lo tak i nei tih hriat chu thil awlsam a ni lo. Mahse, nangmah chauh i ni lo. I medical team te chu i tan an awm reng ang a, i zawhnate an chhang ang a, an thlawp reng ang che. Emotional takin i rilru a buai a nih chuan chu chu i doctor nen pawh sawiho la, tanpuina i hmuh theih tur service te chu zawng rawh.

I hriat reng tur pawimawh ber berte (Take-Home Message) .

Okay, chuti a nih chuan, vawiin a kan sawi tawh atang hian hengte hi i hriat reng tur pawimawh ber berte chu an ni:

• Insulinoma hi benign (a tam zawk chu benign) tumor a ni a, pancreas-ah a lo awm thin. Insulin a siam tam lutuk.
• Hei hian thisen sugar a tlahniam nghal thei (hypoglycemia). Hei hian symptoms a thlen thei a, chu chu luak chhuak, thawk hah, leh thinlung natna te a ni.
• Heng symptoms te hi i tawn fo chuan Doctor pan ngei ngei tur a ni.
• Hei hi special test (darkar 72 chhung chaw nghei test, scan) hmanga hriat theih a ni.
• Enkawlna ber chu surgery a ni. A tam zawkah chuan hei hian a dam kim vek a ni.
• Surgery hma emaw, surgery tih theih loh chuan ei leh in leh damdawi hmangin thisen sugar level hniam chu control theih a ni.
• Hei hi thil awm lo tak ni mah se, a hmaa hriat a nih a, uluk taka enkawl a nih chuan rah tha tak a chhuak thei a ni.

Lungngai suh, natna dang ang bawkin hei hi enkawl dan tur a awm. A pawimawh ber chu a natna lan chhuah dan ngaihven a, a rang thei ang bera damdawi lam thurawn lak hi a ni.

` Insulinoma, pancreas, insulin, thisen sugar hniam, hypoglycemia, tumor, hormone, pancreatic cancer