Insulinoma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Overview

Insulinoma must be differentiated from other diseases that cause features of hypoglycemia like palpitations, profuse sweating, dizziness, such as [differential dx1], [differential dx2], and [differential dx3].

OR

Insulinoma must be differentiated from the exogenous use of insulin, drugs causing hypoglycemia like sulfonylureas.

Differentiating insulinoma from other Diseases

• [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
• [Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

• As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].

Preferred Table for differentials for Hypoglycemia

Diseases	Laboratory Findings differentiating among causes of Hypoglycemia
	S.Glucose (mg/dL)/(mmol/L)	C Peptide (pmol/L)	S.Insulin (μU/mL)/(pmol/L)	S.Proinsulin (pmol/L)	S. Beta hydroxybutyrate	Glucose increase after glucagon(mg/dL)	Oral Hypoglycemic agent	Antibodies to Insulin
Exogenous Insulin	<50/2.5	<200	↑↑
Insulinoma/Nesidioblastosis/PGPH†	'		↑	-
Autoimmune Insulin		↓
Differential Diagnosis 4
Differential Diagnosis 5

† PGPH= Post Gastric Bypass Hypoglycemia