Long Term Medical Treatment of Congenital Hyperinsulinemic Hypoglycemia
Journal Title: Journal of Endocrinology and Diabetes - Year 2014, Vol 1, Issue 1
Abstract
Background: Hyperinsulinism is the most common cause of recurrent hypoglycemia in early infancy. Surgical treatment with partial/near total pancreatectomy has been the mainstay of treatment but does not result in complete remission of hypoglycemia and is associated with high risk of diabetes mellitus Design and methods: We retrospectively reviewed 23 patients (1979-2009) with congenital hyperinsulinism treated medically and surgically. Patients are divided in three groups: 1) treated with diazoxide 2) treated with octreotide alone or along with diazoxide 3) treated with surgical resection. Main outcomes measured are prevention of hypoglycemia, treatment side effects, onset of diabetes mellitus and effects on growth. Results: Eight patients were treated with diazoxide, 10 with octreotide alone or along with diazoxide and 5 had surgical resection. Four patients came off diazoxide between 5.5-10.5 years age, 3 are less than 5 years and still on treatment. Two patients came off octreotide at 5.5 and 7 years and six remain on treatment with their ages between 6 months and 12 years. No patient could come off medical treatment after surgical resection. 2 patients had diabetes in surgical group and none in medical group. Conclusion: Medical therapy with diazoxide, octreotide, glucagon and extensive feeding plan is an effective treatment for control of hypoglycemia in congenital hyperinsulinism patients.
Authors and Affiliations
Noman Ahmad, Mohamad Sharkia, Laura Stewart
Keywords
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- EP ID EP332933
- DOI 10.15226/2374-6890/1/1/00106
- Views 164
- Downloads 0
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