Glucagonoma is a rare tumor that develops in the alpha cells of the pancreas. Its growth usually leads to the increased secretion of glucagon by the pancreas. As stated by the Johns Hopkins Point-of-Care Information Technology Center, (Johns Hopkins POC-IT Center), a small percentage of people with diabetes may actually have glucagonoma instead of actually having "true" Type 2 diabetes.
The high blood sugar level in people with glucagonoma usually results due to the synthesis of glucose in the body brought about by the increased potency of glucagon. This increased potency results from the larger amounts of secretion of glucagon from the tumor.
It is good to know the prevalence of glucagonoma is actually rare. Information from the Johns Hopkins POC-IT Center, indicates around 13 to 14 per 20 million individuals have this particular problem. Less than seven percent of pancreatic tumors are glucagonomas. There is no sexual predilection when it comes to this particular type of pancreatic tumor, but usually it is people in the 40 to 50 years age group who are found to be the ones afflicted by this problem. Sadly, approximately 75 percent of glucagonomas are malignant and most have already spread to distant organs at the time of diagnosis. Approximately 38 to 94 percent of people diagnosed with this type of pancreatic tumor have increased blood sugar levels, which causes their mistaken diagnosis of Type 2 diabetes.
How is glucagonoma diagnosed? If you happen to have increased blood sugar levels, this problem is not enough for diagnosing glucagonoma. Most people with this type of pancreatic tumor have a classical type of skin rash called necrolytic migratory erythema, which are patches of itchy, psoriatic-like large reddish rashes. In most cases, the appearance of this type of rash is the only clue to the diagnosis of glucagonoma.
- once glucagonoma is suspected, glucagon levels are measured. A glucagon level of more than 500 pg / ml strongly suggests the diagnosis of glucagonoma while a measurement of more than 1000 pg / ml is particularly diagnostic.
- an abdominal CT scan with contrast is then performed to visualize the presence of a pancreatic mass.
Most glucagonomas are large at the time of diagnosis and are most often readily localized by physical examination. The appearance of a pancreatic mass requires fine needle biopsy for pathological examination. However, the presence of additional lesions in the liver suggests metastatic problems which will then require additional CT scan-guided biopsy in the liver area.
What are the other signs and symptoms of glucagonoma? Glucagonomas usually have four classical "D" symptoms:
- dermatitis seen as the presence of rashes,
- diabetes brought about by the increased glucagon signal and resulting in increased blood sugar levels,
- deep vein thrombosis … the clotting of blood within the deep veins of the extremities, clinically manifested as swelling and non-abating pain deep within the affected extremity,
Other symptoms that may point out to the diagnosis of this problem include:
- unexplained weight loss,
- increased frequency of urination,
- an increased appetite,
- abdominal pain,
- diarrhea or constipation
How are the resultant high blood sugar levels treated with a diagnosis of glucagonoma?
In this case the diabetes and high blood sugar levels are usually mild. In most cases, Type 2 diabetics who control their diets and use either oral anti-diabetic drugs or insulin injections, can control their blood sugar problem. However, in cases of glucagonoma, the best way to control diabetes is to undergo tumor resection. However, in cases when metastatic lesions are present, standard care for Type 2 diabetes is the only way to go.
Anupam Ghose, a physician by training, was diagnosed with Type 2 Diabetes Mellitus (T2DM) in 2017. After the diagnosis of T2DM, he followed a low carbohydrate high fat diet and reversed his T2DM within a year. Now he has one main goal in life. Yes, it is to make people understand that the conventional method of treating T2DM is not beneficial. The best way to reverse and fight T2DM is through diet and lifestyle modification. He decided to help people suffering from T2DM in their new journey by offering consultations and working together with them in order to achieve a T2DM free life.