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连续血糖监测仪在胰腺神经内分泌肿瘤患者术前低血糖监测与治疗中的应用

USE OF A CONTINUOUS GLUCOSE MONITOR FOR PREOPERATIVE MONITORING AND TREATMENT OF HYPOGLYCEMIA IN A CASE OF PANCREATIC NEUROENDOCRINE TUMOR.

作者信息

Lyerla Ryan C, Bajaj Arrsh, Shrestha Rupendra T

出版信息

AACE Clin Case Rep. 2019 Jun 7;5(4):e255-e258. doi: 10.4158/ACCR-2018-0590. eCollection 2019 Jul-Aug.

Abstract

OBJECTIVE

Pancreatic neuroendocrine tumors secreting proinsulin and insulin could lead to life-threatening hypoglycemia. We aim to show this can be avoided by utilizing continuous glucose monitoring.

METHODS

We describe a case of a 55-year-old female with hypoglycemia unawareness and seizures diagnosed with proinsulinoma. She utilized an intermittently scanned continuous glucose monitor (isCGM) to monitor hypoglycemia preoperatively.

RESULTS

The patient underwent biochemical and radiographic evaluation to confirm the diagnosis of proinsulinoma. Utilizing isCGM to monitor blood glucose, she was able to prevent hypoglycemia-related seizures prior to definitive surgery.

CONCLUSION

In the time leading up to a definitive surgery, patients with proinsulinomas are at risk of hypoglycemic events leading to falls, seizures, and even death. isCGMs can be utilized for preoperative monitoring and treatment of hypoglycemia in these patients.

摘要

目的

分泌胰岛素原和胰岛素的胰腺神经内分泌肿瘤可导致危及生命的低血糖。我们旨在表明,通过使用持续葡萄糖监测可以避免这种情况。

方法

我们描述了一例55岁女性,因低血糖无知觉和癫痫发作被诊断为胰岛素瘤。她在术前使用间歇性扫描式持续葡萄糖监测仪(isCGM)监测低血糖。

结果

患者接受了生化和影像学评估以确诊胰岛素瘤。通过使用isCGM监测血糖,她在确定性手术前能够预防与低血糖相关的癫痫发作。

结论

在进行确定性手术之前的这段时间里,胰岛素瘤患者有发生低血糖事件的风险,这些事件可能导致跌倒、癫痫发作甚至死亡。isCGM可用于这些患者术前低血糖的监测和治疗。

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本文引用的文献

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A Systematic Review of Proinsulin-Secreting Pancreatic Neuroendocrine Tumors.胰岛素分泌性胰腺神经内分泌肿瘤的系统评价
J Gastrointest Surg. 2017 Aug;21(8):1335-1341. doi: 10.1007/s11605-017-3428-8. Epub 2017 May 16.
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Childhood insulinoma masquerading as seizure disorder.伪装成癫痫障碍的儿童胰岛素瘤。
J Paediatr Child Health. 2014 Apr;50(4):319-22. doi: 10.1111/jpc.12399. Epub 2013 Oct 6.
10
Insulinoma presenting as refractory seizure disorder.胰岛素瘤表现为难治性癫痫障碍。
F1000Res. 2012 Sep 21;1:15. doi: 10.12688/f1000research.1-15.v1. eCollection 2012.

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