Management of the Child with Persistent Hypoglycemia After Surgery
Most children with focal hyperinsulinism are cured after surgical excision of the lesion; however, almost half of children with diffuse hyperinsulinism have persistent hypoglycemia after near-total pancreatectomy. A comprehensive assessment of the glycemic status should be undertaken once the patient is on a stable feeding regimen for several days. This assessment includes performing a Cure Fast to demonstrate the resolution of hyperinsulinism in children with focal hyperinsulinism, evaluation for the possibility of post-pancreatectomy diabetes after near-total pancreatectomy, and assessment for persistent hypoglycemia in children with diffuse hyperinsulinism. Treatment of persistent hyperinsulinism following pancreatectomy requires an individualized approach and often requires a combination of therapies to achieve a suitable regimen that can safely and reasonably be carried out at home.
KeywordsPancreatectomy Hyperglycemia Hypoglycemia
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