Medical Management of Hyperinsulinism

  • Khalid Hussain
  • Thomas Meissner
  • Jean-Baptiste ArnouxEmail author
Part of the Contemporary Endocrinology book series (COE)


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.


Diazoxide Glucagon Octreotide Lanreotide mTOR inhibitor Calcium blockers Enteral feeding 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Khalid Hussain
    • 1
  • Thomas Meissner
    • 2
  • Jean-Baptiste Arnoux
    • 3
  1. 1.Department of Pediatric Medicine, Division of EndocrinologySidra MedicineDohaQatar
  2. 2.Department of Pediatric EndocrinologyUniversity Children’s HospitalDüsseldorfGermany
  3. 3.Reference Centre for Inherited Metabolic Diseases, Necker-Enfants Malades HospitalParis Descartes University, APHPParisFrance

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