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Case report
Malignant insulinoma hypoglycaemia: complex palliative management
  1. Lauri Simkiss1,
  2. Frances Hakkak2 and
  3. Rajeev Raghavan3
  1. 1Specialist Palliative Care Team, University Hospital of North Tees, Stockton-on-Tees, UK
  2. 2Palliative Care, Compton Care, Wolverhampton, West Midlands, UK
  3. 3Wolverhampton Diabetes Centre, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
  1. Correspondence to Dr Lauri Simkiss, Specialist Palliative Care Team, University Hospital of North Tees, Stockton-on-Tees TS19 8PE, UK; lauri.simkiss{at}doctors.org.uk

Abstract

This case presentation describes a 65-year-old woman with metastatic malignant insulinoma who experienced frequent episodes of hypoglycaemia causing significant distress and burden to her quality of life. The report describes how medical management was altered and how the patient was supported in order to alleviate these burdens. In particular, the report highlights the first documented use of flash glucose monitoring in insulinoma, which was beneficial in reducing the discomfort of lancet use and anxiety associated with hypoglycaemic episodes. This case demonstrates the benefits of an individualised approach, collaboration with other specialisms and recommends further evaluation of the use of flash glucose monitoring in palliative care.

  • pancreatic
  • quality of life
  • paraneoplastic disorders
  • symptoms and symptom management

https://doi.org/10.1136/bmjspcare-2021-003188

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    Footnotes

    • Twitter @laurisimkiss

    • Contributors LS was a speciality trainee who managed the patient while admitted to the hospice inpatient unit, acquired the patient information and wrote the manuscript. FH was a palliative medicine consultant involved in the management of the patient whilst admitted to the hospice inpatient unit and provided critical revision of the manuscript. RR was the Consultant in Diabetes and Endocrinology who led the management of the patient following diagnosis and provided specialist advice while the patient was admitted to the hospice inpatient unit, and provided critical revision of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.