Synonyms for hyperinsulinism or Related words with hyperinsulinism
Examples of "hyperinsulinism"
A low carbohydrate diet is particularly effective in reducing
Insulin levels above 3 μU/mL are inappropriate when the glucose level is below 50 mg/dL (2.8 mM), and may indicate
as the cause of the hypoglycemia. The treatment of this form of
depends on the cause and the severity of the
, and may include surgical removal of the source of insulin, or a drug such as diazoxide or octreotide that reduces insulin secretion.
In terms of the investigation of congenital
, valuable diagnostic information is obtained from a blood sample drawn during hypoglycemia, detectable amounts of insulin during hypoglycemia are abnormal and indicate that
is likely to be the cause. Inappropriately low levels of free fatty acids and ketones provide additional evidence of insulin excess. An additional piece of evidence indicating
is a usually high requirement for intravenous glucose to maintain adequate glucose levels, the minimum glucose required to maintain a plasma glucose above 70 mg/dl. A GIR above 8 mg/kg/minute in infancy suggests
. A third form of evidence suggesting
is a rise of the glucose level after injection of glucagon at the time of the low glucose.
due to diffuse overactivity of beta cells, such as in many of the forms of congenital
, and more rarely in adults, can often be treated with diazoxide or a somatostatin analog called octreotide. Diazoxide is given by mouth, octreotide by injection or continuous subcutaneous pump infusion. When congenital
is due to focal defects of the insulin-secretion mechanism, surgical removal of that part of the pancreas may cure the problem. In more severe cases of persistent congenital
unresponsive to drugs, a near-total pancreatectomy may be needed to prevent continuing hypoglycemia. Even after pancreatectomy, continuous glucose may be needed in the form of gastric infusion of formula or dextrose.
Three subtypes of CDG I (a,b,d) can cause congenital
with hyperinsulinemic hypoglycemia in infancy.
There are differenct types of congenital
as "diffuse and focal" indicated below:
Dr. Seale Harris first diagnosed
in 1924 and also is credited with the recognition of spontaneous hypoglycemia.
High dose glucocorticoid is an older treatment used for presumptive transient
but incurs side effects with prolonged use.
However, the term has been resurrected in recent years to describe a form of "acquired"
with beta cell hyperplasia found in adults, especially after gastrointestinal surgery.
Mutations alter the allosteric binding site of GTP cause permanent activation of glutamate dehydrogenase lead to disorder known as
Clinical features and circumstances can provide other indirect evidence of
. For instance, babies with neonatal
are often large for gestational age and may have other features such as enlarged heart and liver. Knowing that someone takes insulin or oral hypoglycemic agents for diabetes obviously makes insulin excess the presumptive cause of any hypoglycemia.
Typical fasting insulin levels found in this type of
are above 20 μU/mL. When resistance is severe, levels can exceed 100 μU/mL.
might be a cause of symptomatic hypoglycemia was first proposed by Seale Harris, MD, 1924, in "Journal of the American Medical Association".
In addition to being a risk factor for type 2 diabetes,
due to insulin resistance may increase blood pressure and contribute to hypertension by direct action on vascular endothelial cells (the cells lining blood vessels).
has also been implicated as a contributing factor in the excessive production of androgens in polycystic ovary syndrome.
Several treatments are used for hyperinsulinemic hypoglycemia, depending on the exact form and severity. Some forms of congenital
respond to diazoxide or octreotide. Surgical removal of the overactive part of the pancreas is curative with minimal risk when
is focal or due to a benign insulin-producing tumor of the pancreas. When congenital
is diffuse and refractory to medications, near-total pancreatectomy may be the treatment of last resort, but in this condition is less consistently effective and fraught with more complications.
By the 1970s, nesidioblastosis was primarily used to describe the pancreatic dysfunction associated with persistent congenital
and in most cases from the 1970s until the 1980s, it was used as a synonym for what is now referred to as congenital
. Most congenital
is caused by different mechanisms than excessive proliferation of beta cells in a fetal pattern and the term fell into disfavor after it was recognized in the late 1980s that the characteristic tissue features were sometimes seen in pancreatic tissue from normal infants and even adults, and is not consistently associated with hyperinsulinemic hypoglycemia.
The differential diagnosis of congenital
is consistent with PMM2-CDG, as well as several syndromes. Among other DDx we find the following that are listed:
The SUR1 protein is coded by the "ABCC8" gene and is associated with congenital
and susceptibility to type 2 diabetes.
The principal treatments of
due to insulin resistance are measures that improve insulin sensitivity, such as weight loss, physical exercise, and drugs such as thiazolidinediones or metformin.
may also refer to forms of hypoglycemia caused by excessive insulin secretion. In normal children and adults, insulin secretion should be minimal when blood glucose levels fall below 70 mg/dL (3.9 mM). There are many forms of hyperinsulinemic hypoglycemia caused by various types of insulin excess. Some of those that occur in infants and young children are termed congenital
. In adults, severe hyperinsulinemic hypoglycemia is often due to an insulinoma, an insulin-secreting tumor of the pancreas.
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