NationMaster - Encyclopedia: Hyperinsulinemic hypoglycemia

Hyperinsulinemic hypoglycemia describes the condition and effects of low blood glucose caused by excessive insulin. Hypoglycemia due to excess insulin is the most common type of serious hypoglycemia. It can be due to endogenous or injected insulin. Hypoglycemia due to endogenous insulin can be congenital or acquired, apparent in the newborn period, or many years later. The hypoglycemia can be severe and life-threatening or a minor, occasional nuisance. By far the most common type of severe but transient hyperinsulinemic hypoglycemia occurs accidentally in persons with type 1 diabetes who take insulin. Glucose (Glc), a monosaccharide, is one of the most important carbohydrates. ... The structure of insulin Red: carbon; green: oxygen; blue: nitrogen; pink: sulfur. ... Hypoglycemia is a medical term referring to a pathologic state produced by a lower than normal amount of sugar (glucose) in the blood. ... This article is about the disease that features high blood sugar. ...

Congenital hyperinsulinism is a medical term referring to a variety of congenital disorders in which hypoglycemia is caused by excessive insulin secretion. ... In biology, mutations are changes to the genetic material (usually DNA or RNA). ... Glucokinase Glucokinase (EC 2. ... Hyperammonemia is a metabolic disturbance characterised by an excess of ammonia in the blood. ... Beckwith-Wiedemann syndrome (BWS) is a very rare genetic overgrowth syndrome (prevalence of about 1 in 36,000). ... Insulin-like growth factor 2 (IGF-2) is a protein hormone similar in molecular structure to insulin. ... An insulinoma is a tumour of the pancreas derived from the beta cells which while retaining the ability to synthesize and secrete insulin is autonomous of the normal feedback mechanisms. ... Tumor (American English) or tumour (British English) originally means swelling, and is sometimes still used with that meaning. ... Nesidioblastosis is an obsolete medical term for persistent congenital hyperinsulinism. ... Reactive hypoglycemia is a medical term describing recurrent episodes of hypoglycemia occurring 2-4 hours after a high carbohydrate meal (or oral glucose load). ... Idiopathic postprandial syndrome is a medical term describing a collection of symptoms popularly attributed to hypoglycemia but without demonstrably low glucose levels. ... Gastric dumping syndrome, or rapid gastric emptying, happens when the lower end of the small intestine, the jejunum, fills too quickly with undigested food from the stomach. ... Sulfonylurea derivatives are a class of antidiabetic drugs that are used in the management of diabetes mellitus type 2 (adult-onset). They act by increasing insulin release from the beta cells in the pancreas. ... Aspirin or acetylsalicylic acid is a drug in the family of salicylates, often used as an analgesic (against minor pains and aches), antipyretic (against fever), and anti-inflammatory. ... Pentamidine isethionate is a drug primarily given for prevention and treatment of Pneumocystis carinii pneumonia (PCP), a type of pneumonia often seen in people with HIV infection. ... Quinine, C20H24N2O2, is a natural white crystalline alkaloid having antipyretic, anti-malarial and analgesic properties and a bitter taste. ... A vaccine is an antigenic preparation used to produce active immunity to a disease, in order to prevent or ameliorate the effects of infection by any natural or wild strain of the organism. ... This article is about the disease that features high blood sugar. ... Diabetic hypoglycemia describes low blood glucose (hypoglycemia) occurring in a person with diabetes mellitus. ... Munchausen syndrome is a form of psychological disorder known as a factitious disorder (the term Munchausen syndrome is sometimes used, incorrectly, to refer to any form of factitious disorder). ... Located at the base of the skull, the pituitary gland is protected by a bony structure called the sella turcica. ... This article is in need of attention from an expert on the subject. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... Leucine is one of the 20 most common amino acids and coded for by DNA. It is isomeric with isoleucine. ... Tolbutamide is a sulfonylurea oral hypoglycemic drug sold under the brand name Orinase. ... Clinical depression is a state of sadness or melancholia that has advanced to the point of being disruptive to an individuals social functioning and/or activities of daily living. ...

Signs, symptoms, and potential effects

Manifestations of hyperinsulinemic hypoglycemia vary by age and severity of the hypoglycemia. In general, most signs and symptoms can be attributed to (1) the effects on the brain of insufficent glucose (neuroglycopenia) or (2) to the adrenergic response of the autonomic nervous system to hypoglycemia. A few miscellaneous symptoms are harder to attribute to either of these causes. In most cases, all effects are reversed when normal glucose levels are restored. Neuroglycopenia is a medical term that refers to a shortage of glucose (glycopenia) in the brain, usually due to hypoglycemia. ... Epinephrine (INN) or adrenaline (BAN) is a hormone and a neurotransmitter. ... This article is in need of attention from an expert on the subject. ...

There are uncommon cases of more persistent harm, and rarely even death due to severe hypoglycemia of this type. One reason hypoglycemia due to excessive insulin can be more dangerous is that insulin lowers the available amounts of most alternate brain fuels, such as ketones. Brain damage of various types ranging from stroke-like focal effects to impaired memory and thinking can occur. Children who have prolonged or recurrent hyperinsulinemic hypoglycemia in infancy can suffer harm to their brains and may be developmentally delayed. A ketone is either the functional group characterized by a carbonyl group linked to two other carbon atoms or a compound that contains this functional group. ... A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted. ... Mental retardation (abbreviated as MR), is a term for a pattern of persistently slow learning of basic motor and language skills (milestones) during childhood, and a significantly below-normal intellectual capacity as an adult. ...

Diagnostic evaluation

When the cause of hypoglycemia is not obvious, the most valuable diagnostic information is obtained from a blood sample (a "critical specimen") drawn during the hypoglycemia. Detectable amounts of insulin are abnormal and indicate that hyperinsulinism is likely to be the cause. Other aspects of the person's metabolic state, especially low levels of free fatty acids, beta-hydroxybutyrate and ketones, and either high or low levels of C-peptide and proinsulin can provide confirmation. In chemistry, especially biochemistry, a fatty acid is a carboxylic acid (or organic acid), often with a long aliphatic tail (long chains), either saturated or unsaturated. ... A ketone is either the functional group characterized by a carbonyl group linked to two other carbon atoms or a compound that contains this functional group. ... C-peptide is a peptide which is made when proinsulin is split into insulin and C-peptide. ... Proinsulin is the substance made first in the pancreas that is then made into insulin. ...

Clinical features and circumstances can provide other indirect evidence of hyperinsulinism. For instance, babies with neonatal hyperinsulinism 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. Birth weight is the weight of a baby at its birth. ... An oral hypoglycemic agent is a medication (usually a pill or capsule) that can be take by mouth to lower a high blood sugar toward normal. ...

Most sulfonylureas and aspirin can be detected on a blood or urine drug screen tests, but insulin cannot. Endogenous and exogenous insulin can be distinguished by the presence or absence of C-peptide, a by-product of endogenous insulin secretion which is not present in pharmaceutical insulin. Some of the newer analog insulins are not measured by the usual insulin level assays. C-peptide is a peptide which is made when proinsulin is split into insulin and C-peptide. ... Novo Nordisks NovoLogÂ® substituting a single amino acid Aventiss LantusÂ® substituting a single amino acid and adding two extra amino acids to the c-terminus of the b-chain Glargine versus NPH insulin in duration Through genetic engineering of the underlying DNA, the primary amino acid sequence of...

Treatment

Acute hypoglycemia is reversed by raising the blood glucose. This is usually accomplished by eating or drinking 10-30 grams of carbohydrate. Carbohydrate is digested and raises blood sugar most rapidly if it is not eaten with protein or fat. When hypoglycemia is more severe or carbohydrate cannot be given by mouth, glucagon can be injected intramuscularly or intravenously, or dextrose can be infused intravenously to raise the blood glucose. Most people recover fully even from severe hypoglycemia after the blood glucose is restored to normal. Recovery time varies from minutes to hours depending on the severity and duration of the hypoglycemia. Death or permanent brain damage resembling stroke can occur rarely as a result of severe hypoglycemia. See hypoglycemia for more on effects, recovery, and risks. Carbohydrates are chemical compounds that contain oxygen, hydrogen, and carbon atoms. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... Glucagon ball and stick model Glucagon is a 29-amino acid polypeptide acting as an important hormone in carbohydrate metabolism. ... A space-filling model of glucose Glucose, a simple monosaccharide sugar, is one of the most important carbohydrates and is used as a source of energy in animals and plants. ... A stroke or cerebrovascular accident (CVA) occurs when the blood supply to a part of the brain is suddenly interrupted. ... Hypoglycemia is a medical term referring to a pathologic state produced by a lower than normal amount of sugar (glucose) in the blood. ...

Most hypoglycemia due to excessive insulin occurs in people who take insulin for type 1 diabetes. Management of this hypoglycemia is sugar or starch by mouth (or in severe cases, an injection of glucagon or intravenous dextrose). When the glucose has been restored, recovery is usually complete. Prevention of further episodes consists of maintaining balance between insulin, food, and exercise. Management of hypoglycemia due to treatment of type 2 diabetes is similar, and the dose of the oral hypoglycemic agent may need to be reduced. Reversal and prevention of hypoglycemia is a major aspect of the management of type 1 diabetes. Diabetes mellitus is a medical disorder characterized by varying or persistent hyperglycemia (elevated blood sugar levels), especially after eating. ... Diabetic hypoglycemia describes low blood glucose (hypoglycemia) occurring in a person with diabetes mellitus. ... Glucagon ball and stick model Glucagon is a 29-amino acid polypeptide acting as an important hormone in carbohydrate metabolism. ... A space-filling model of glucose Glucose, a simple monosaccharide sugar, is one of the most important carbohydrates and is used as a source of energy in animals and plants. ... Diabetes mellitus type 2 (formerly Diabetes mellitus type II and also known as non-insulin-dependent diabetes, NIDDM or adult-onset diabetes) is a long-term metabolic disorder that is primarily characterized by insulin resistance, hyperglycemia, relative insulin deficiency and obesity. ... An oral hypoglycemic agent is a medication (usually a pill or capsule) that can be take by mouth to lower a high blood sugar toward normal. ...

Hypoglycemia due to drug overdose or effect is supported with extra glucose until the drugs have been metabolized. The drug doses or combination often needs to be altered.

Hypoglycemia due to a tumor of the pancreas or elsewhere is usually curable by surgical removal. Most of these tumors are benign. Streptozotocin is a specific beta cell toxin and has been used to treat insulin-producing pancreatic carcinoma. Tumor (American English) or tumour (British English) originally means swelling, and is sometimes still used with that meaning. ... Streptozotocin (STZ, Zanosar) is a drug used in treating cancer of the pancreas. ... Beta cells are a type of cell in the pancreas in areas called the islets of Langerhans. ... In medicine, carcinoma is any cancer that arises from epithelial cells. ...

Hyperinsulinism due to diffuse overactivity of beta cells, such as in many of the forms of congenital hyperinsulinism, 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 hyperinsulinism 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 hyperinsulinism 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. Congenital hyperinsulinism is a medical term referring to a variety of congenital disorders in which hypoglycemia is caused by excessive insulin secretion. ... Diazoxide is a potassium channel activator, which causes local relaxation in smooth muscle by increasing membrane permeability to potassium ions. ... Somatostatin is a hormone. ... Somatostatin is a hormone. ... Pancreatectomy is a medical term referring to removal by surgery of part or all of the pancreas. ... An infant being fed by bottle. ...

High dose glucocorticoid is an older treatment used for presumptive transient hyperinsulinism but incurs side effects with prolonged use. Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ...

Contents

Signs, symptoms, and potential effects

Diagnostic evaluation

Treatment

See also

Contents

Signs, symptoms, and potential effects GA_googleFillSlot("encyclopedia_square");

Diagnostic evaluation

Treatment

See also

Signs, symptoms, and potential effects