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Medical Management of Hyperinsulinism

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Congenital Hyperinsulinism

Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Congenital hyperinsulinism (HI) comprises conditions of various initial severities, which might improve with time. Short-term management, to normalize glycemia and avoid brain damage, frequently includes the use of glucagon and intravenous and/or enteral dextrose. A long-term medical management plan is considered when the condition does not resolve over a few days or is not curable by a selective and partial pancreatectomy. The long-term management plan must be tailored for each patient, weighting the limitations, side effects, and contraindications of each drug. When the patient is not responsive to diazoxide, the first-line oral treatment, treatment with a somatostatin analogue is usually considered. If the efficacy of somatostatin analogues is not sufficient to prevent hypoglycemia, alternative measures may include carbohydrate-enriched diets, sometimes through an enteral tube (nasogastric or gastric) and/or continuous enteral dextrose.

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Authors and Affiliations

  1. Department of Pediatric Medicine, Division of Endocrinology, Sidra Medicine, Doha, Qatar

    Khalid Hussain

  2. Department of Pediatric Endocrinology, University Children’s Hospital, Düsseldorf, Germany

    Thomas Meissner

  3. Reference Centre for Inherited Metabolic Diseases, Necker-Enfants Malades Hospital, Paris Descartes University, APHP, Paris, France

    Jean-Baptiste Arnoux

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  1. Khalid Hussain
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  3. Jean-Baptiste Arnoux
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Correspondence to Jean-Baptiste Arnoux .

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Editors and Affiliations

  1. Division of Endocrinology and Diabetes, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Diva D. De León-Crutchlow

  2. Division of Endocrinology and Diabetes, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Charles A. Stanley

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Hussain, K., Meissner, T., Arnoux, JB. (2019). Medical Management of Hyperinsulinism. In: De León-Crutchlow, D., Stanley, C. (eds) Congenital Hyperinsulinism. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-030-02961-6_6

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