Chinese Medical Sciences Journal ›› 2024, Vol. 39 ›› Issue (2): 102-110.doi: 10.24920/004329

• Research Articles • Previous Articles     Next Articles

Efficacy of Raw Corn Starch in Insulinoma-Related Hypoglycemia: A Promising Supportive Therapy

Rong-Rong Li1, Wei Chen1, *(), Xin-Hua Xiao2, Miao Yu2, Fan Ping2, Lian Duan2   

  1. 1Department of Clinical Nutrition, Beijing Key Laboratory of the Innovative Development of Functional Staple and the Nutritional Intervention for Chronic Disease, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
    2Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2023-12-11 Accepted:2024-04-11 Published:2024-06-30 Online:2024-05-17
  • Contact: * txchenwei@sina.com
To provide evidence to validate the efficacy and safety of raw corn starch in improving insulinoma-associated hypoglycemia, the authors from Peking Union Medical College Hospital retrospectively analyzed the therapeutic effects of raw corn starch intervention preoperatively on blood glucose control, weight change, and adverse events in insulinoma patients, and they concluded that the RCS-supplemented diet is effective in controlling insulinoma-induced hypoglycemia.

Objective To investigate the efficacy of raw corn starch (RCS) in clinical management of insulinoma-induced hypoglycemia.
Methods We retrospectively collected clinical data of insulinoma patients who received RCS-supplemented diet preoperatively, and analyzed the therapeutic effects of the RCS intervention on blood glucose control, weight change, and its adverse events.
Results The study population consisted of 24 cases of insulinoma patients, 7 males and 17 females, aged 46.08±14.15 years. Before RCS-supplemented diet, all patients had frequent hypoglycemic episodes (2.51±3.88 times/week), concurrent with neuroglycopenia (in 83.3% of patients) and autonomic manifestations (in 75.0% of patients), with the median fasting blood glucose (FBG) of 2.70 (interquartile range [IQR]: 2.50-2.90) mmol/L. The patients' weight increased by 0.38 (IQR: 0.05-0.65) kg per month, with 8 (33.3%) cases developing overweight and 7 (29.2%) cases developing obesity. All patients maintained the RCS-supplemented diet until they underwent tumor resection (23 cases) and transarterial chemoembolization for liver metastases (1 case). For 19 patients receiving RCS throughout the day, the median FBG within one week of nutritional management was 4.30 (IQR: 3.30-5.70) mmol/L, which was a significant increase compared to pre-nutritional level [2.25 (IQR: 1.60-2.90) mmol/L; P < 0.001]. Of them, 10 patients receiving RCS throughout the day for over four weeks had sustained improvement in FBG compared to pre-treatment [3.20 (IQR: 2.60-3.95) mmol/L vs. 2.15 (IQR: 1.83-2.33) mmol/L; P < 0.001). Five patients who received RCS only at night also had a significant increase in FBG within one week of nutritional management [3.50 (IQR: 2.50-3.65) mmol/L vs. 2.20 (IQR:1.80-2.60) mmol/L; P < 0.001], but only one patient who continued to receive RCS for over four weeks did not have a significant improvement in FBG. No improvement in weight gain was observed upon RCS supplementation. Mild diarrhea (2 cases) and flatulence (1 case) occurred, and were relieved by reduction of RCS dose.
Conclusion The RCS-supplemented diet is effective in controlling insulinoma-induced hypoglycemia.

Key words: corn starch, hypoglycemia, insulinoma, nutrition therapy

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