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Topic: Hyperinsulinemic hypoglycemia

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Hypoglycemia

Congenital hyperinsulinism

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	Hyperinsulinemic hypoglycemia - Wikipedia, the free encyclopedia
		Hyperinsulinemic hypoglycemia describes the condition and effects of low blood glucose caused by excessive insulin.
		Management of this hypoglycemia is sugar or starch by mouth (or in severe cases, an injection of glucagon or intravenous dextrose).
		Hypoglycemia due to a tumor of the pancreas or elsewhere is usually curable by surgical removal.
	en.wikipedia.org /wiki/Hyperinsulinemic_hypoglycemia (953 words)

	Hypoglycemia - Wikipedia, the free encyclopedia
		Hypoglycemia is a medical term referring to a pathologic state produced by a lower than normal amount of sugar (glucose) in the blood.
		Hypoglycemia due to hormone deficiencies such as hypopituitarism or adrenal insufficiency usually ceases when the appropriate hormone is replaced.
		Hypoglycemia is also a term of contemporary American folk medicine which refers to a recurrent state of symptoms of altered mood and cognitive efficiency, sometimes accompanied by adrenergic symptoms, but not necessarily by measured low blood glucose.
	en.wikipedia.org /wiki/Hypoglycemia (4471 words)

	Pitfalls in the Evaluation of Spontaneous Hyperinsulinemic Hypoglycemia
		Sulfonylurea-induced hypoglycemia is biochemically indistinguishable from hypoglycemia caused by insulinoma.
		Hypoglycemia of 1.1 mmol/l (20 mg/dl) was revealed as the cause of coma when she reached the emergency room.
		Hypoglycemia of 1.2 mmol/l was detected, and she promptly responded to intravenous application of glucose.
	journal.diabetes.org /diabetesspectrum/00v13n1/pg56.htm (2525 words)

	Hypoglycemia (Site not responding. Last check: 2007-11-03)
		Hypoglycemia should always be excluded as the cause of an initial episode of convulsions, coma, or a sudden alteration of neurobehavioral functioning.
		Hypoglycemia occurs within two hours of glucose ingestion and is associated with an even earlier hyperglycemic phase due to the rapid absorption of glucose with prompt insulin secretion.
		The term functional hypoglycemia has been used to describe such patients, many of whom may have emotional complaints that are unrelated to the prevailing blood glucose concentration and whose symptom complex may be triggered by placebo rather than by glucose.
	home.coqui.net /myrna/hypog.htm (2000 words)

	Diabetes: Hypoglycemia Per Se Stimulates Sympathetic Neur... @ HighBeam Research (Site not responding. Last check: 2007-11-03)
		Iatrogenic hypoglycemia in type 1 diabetes is the result of the interplay of relative or absolute therapeutic insulin excess--which must occur from time to time because of the imperfections in current insulin replacement regimens--and compromised glucose counterregulation, rather than insulin excess alone (3).
		It is widely held that hypoglycemia stimulates the sympathetic neural as well as the adrenomedullary component of the sympathochromaffin (sympathoadrenal) system (although that premise has been questioned recently [26]) and that the glycemic thresholds for sympathetic neural responses to hypoglycemia, like those for adrenomedullary responses, are shifted to lower plasma glucose concentrations after recent hypoglycemia.
		In addition to the epinephrine responses, plasma pancreatic polypeptide (a marker of parasympathetic neural activity) and growth hormone responses to hyperinsulinemic hypoglycemia were reduced, and plasma glucagon and cortisol responses and neurogenic and neuroglycopenic symptom responses tended to be reduced, after recent hypoglycemia.
	www.highbeam.com /library/doc0.asp?DOCID=1G1:55124451&refid=holomed_1 (5690 words)

	Reduced responses to hypoglycemia ...
		This appears to be due to reduced responsiveness to a given level of hypoglycemia rather than to reduced sensitivity to hypoglycemia, since the glycemic thresholds for several responses are similar in women and in men [3, 4].
		That is sufficient time to reverse hypoglycemia unawareness and increase the reduced epinephrine response to hypoglycemia [6, 7], both the result of recent antecedent iatrogenic hypoglycemia [8].
		While the severe hypoglycemia event rate was higher in women in the conventional therapy group (23.3 vs 14.6 episodes per 100 patient-years, p < 0.05), that was not the case in the intensive therapy group (58.7 vs 63.6 episodes per 100 patient-years).
	www.medforum.nl /idm/reduced_responses_to_hypoglucemia____.htm (864 words)

	Persistent Hyperinsulinemic Hypoglycemia In Neonates (Site not responding. Last check: 2007-11-03)
		Recurrent hypoglycemia in neonates and infants is due to persistent hyperinsulinemia.
		Most cases of persistent hyperinsulinemic hypoglycemia of infancy (PHHI) in neonates do not respond to medical treatment and need to be treated with pancreatectomy, whereas about half of the infancy onset patients can be managed medically.
		Neurologic outcomes of 90 neonates and infants with persistent hyperinsulinemic hypoglycemia.
	www.indegene.com /Ped/Jour/indJour_PED_Sum_01-03-2001_1.asp (412 words)

	eMedicine - Hypoglycemia : Article by Robert Hoffman, MD (Site not responding. Last check: 2007-11-03)
		Hypoglycemia occurs when one or more of these counterregulatory mechanisms fail, either through glucose overutilization as in hyperinsulinism, underproduction as in the glycogen storage diseases, or a combination of the two as in growth hormone or cortisol deficiency.
		Hyperinsulinism (infant of a mother with diabetes, persistent hyperinsulinemic hypoglycemia of infancy, insulin-producing tumors, child abuse): Hyperinsulinism causes excess glucose utilization primarily by its stimulatory effect on glucose uptake by skeletal muscle.
		The usual initial operation in the infant with persistent hyperinsulinemic hypoglycemia of infancy is to remove 95% of the pancreas.
	www.emedicine.com /ped/topic1117.htm (4055 words)

	[No title]
		One important symptom of hypoglycemia is often a disturbance of mental processes, and I suspect that the victimâs perceptions of time may have gone awry.
		Hypoglycemia, also called low blood sugar, occurs when the body's insulin level is too high and blood glucose (sugar) level drops too low to provide enough...
		Hypoglycemia, or low blood sugar, is manifested by sweating, shaking, hunger and sometimes confusion.
	health.cancer-help.org /include/072805/Hypoglycemia.txt (1631 words)

	eMedicine - Pediatrics, Hypoglycemia : Article by Hilarie Cranmer, MD, MPH, FACEP (Site not responding. Last check: 2007-11-03)
		Causes of hypoglycemia in neonates differ slightly from the causes of hypoglycemia in older infants and children.
		Postprandial hypoglycemia is rare in children in the absence of prior gastrointestinal (GI) surgery.
		The pathophysiology of hypoglycemia is analogous to adults.
	www.emedicine.com /emerg/topic384.htm (2716 words)

	Specialty Laboratories ::: we help doctors help patients
		Robert Wassman, M.D. Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is caused by insulin hypersecretion, with consequent severe nonketotic hypoglycemia, and often brain damage or death in newborn infants.
		Mutations in the sulfonylurea receptor gene in familial persistent hyperinsulinemic hypoglycemia of infancy.
		Familial persistent hyperinsulinemic hypoglycemia of infancy and mutations in the sulfonylurea receptor.
	www.specialtylabs.com /books/print_view.asp?id=219 (358 words)

	Effects of recurrent hyperinsulinemia with and without hypoglycemia on counterregulation in diabetic rats -- Inouye et ...
		to subsequent hypoglycemia (15, 16, 44, 46, 48, 49),
		Recently, we examined the effects of recurrent hyperinsulinemia and hypoglycemia on counterregulation in normal rats (52).
		Hypoglycemia in insulin-dependent diabetes mellitus: interplay of insulin excess and compromised glucose counterregulation.
	ajpendo.physiology.org /cgi/content/full/282/6/E1369 (5821 words)

	Indian Pediatrics - Editorial
		Persistent hyperinsulinemic hypoglycemia or Nesidioblastosis is an uncommon cause of neonatal hypoglycemia.
		He had repeated episodes of severe hypoglycemia and seizures even at glucose infusion rates of more than 15 mg/kg/min, requiring additional corticosteroids and glucagon to achieve euglycemia.
		A diagnosis of persistent hyperinsulinemic hypoglycemia of infancy was made.
	www.indianpediatrics.net /august2000/august-890-893.htm (1062 words)

	Diabetes: Severe persistent hyperinsulinemic hypoglycemia... @ HighBeam Research
		We describe the first case of severe persistent hyperinsulinemic hypoglycemia due to a "de novo" mutation in GCK (Y214C).
		In conclusion, we have identified a de novo GCK activating mutation that causes hyperinsulinemic hypoglycemia of exceptional severity.
		Failure of the pancreatic [beta]-cell to suppress insulin secretion during hypoglycemia is the pathophysiological basis of persistent hyperinsulinemic hypoglycemia of infancy (PHHI).
	www.highbeam.com /library/doc0.asp?DOCID=1G1:120259774&refid=holomed_1 (3129 words)

	UpToDate Persistent hyperinsulinemic hypoglycemia of infancy
		— Persistent hyperinsulinemic hypoglycemia of infancy (PHHI), previously called familial hyperinsulinism, congenital hyperinsulinemia, and primary islet cell hypertrophy (nesidioblastosis), is the most common cause of persistent hypoglycemia in infancy.
		The clinical manifestations range from life-threatening hypoglycemia presenting on the first day of life to only mildly symptomatic hypoglycemia in a child or adolescent that may be difficult to identify.
		The net effect is the release of insulin despite the presence of hypoglycemia [8].
	patients.uptodate.com /topic.asp?file=pediendo/14471 (486 words)

	Cardiac responses to insulin-induced hypoglycemia in nondiabetic and intensively treated type 1 diabetic patients -- ...
		As expected, the counterregulatory response to hypoglycemia was blunted in the diabetic subjects (Fig.
		Iatrogenic hypoglycemia as a cause of hypoglycemia-associated autonomic failure in IDDM.
		Hypoglycemia-induced autonomic failure in IDDM is specific for stimulus of hypoglycemia and is not attributable to prior autonomic activation.
	ajpendo.physiology.org /cgi/content/full/281/5/E1029 (4417 words)

	APStracts 9:0074E, 2002. (Site not responding. Last check: 2007-11-03)
		To understand the mechanisms by which recurrent hypoglycemia increases the risk of subsequent hypoglycemia it was necessary to differentiate the effects of recurrent hyperinsulinemia from those of hyperinsulinemic-hypoglycemia.
		We conclude that recurrent hypoglycemia may increase the risk of subsequent hypoglycemia by increasing peripheral insulin sensitivity.
		Moreover, of all the counterregulatory responses, epinephrine responses are particularly sensitive to impairment by recurrent hypoglycemia.
	www.uth.tmc.edu /apstracts/2002/endo/April/74e.html (388 words)

	A Novel Syndrome of Autosomal-Dominant Hyperinsulinemic Hypoglycemia Linked to a Mutation in the Human Insulin Receptor ...
		hypoglycemia in children and adults remain unexplained (5,6).
		hyperinsulinemic hypoglycemia with onset in adolescence to adulthood
		Thomas PM: Genetic mutations as a cause of hyperinsulinemic hypoglycemia in children.
	diabetes.diabetesjournals.org /cgi/content/full/53/6/1592 (4049 words)

	Laparoscopic Diagnosis and Cure of Hyperinsulinism in Two Cases of Focal Adenomatous Hyperplasia in Infancy -- De ... (Site not responding. Last check: 2007-11-03)
		Partial elective pancreatectomy is curative in focal form of permanent hyperinsulinemic hypoglycaemia in infancy: a report of 45 cases from 1983 to 2000.
		Laparoscopic identification and removal of focal lesions in persistent hyperinsulinemic hypoglycemia of infancy [abstract].
		Reinecke-Luthge A, Koschoreck F, Kloppel G. The molecular basis of persistent hyperinsulinemic hypoglycemia of infancy and its pathologic substrates.
	pediatrics.aappublications.org /cgi/content/full/114/4/e520 (2007 words)

	Noninsulinoma Pancreatogenous Hypoglycemia: A Novel Syndrome of Hyperinsulinemic Hypoglycemia in Adults Independent of ... (Site not responding. Last check: 2007-11-03)
		is chronic in noninsulin-mediated hypoglycemia and is prolonged
		1982 Hyperinsulinemic hypoglycemia in adults with islet cell hyperplasia and degranulation of exocrine cells of the pancreas.
		1980 Diagnosis of pancreatic islet hyperplasia causing hypoglycemia in a patient with portacaval anastomosis.
	jcem.endojournals.org /cgi/content/full/84/5/1582 (4342 words)

	Somatic Deletion of the Imprinted 11p15 Region in Sporadic Persistent Hyperinsulinemic Hypoglycemia of Infancy Is ... (Site not responding. Last check: 2007-11-03)
		Somatic Deletion of the Imprinted 11p15 Region in Sporadic Persistent Hyperinsulinemic Hypoglycemia of Infancy Is Specific of Focal Adenomatous Hyperplasia and Endorses Partial Pancreatectomy -- Lonlay et al.
		Somatic Deletion of the Imprinted 11p15 Region in Sporadic Persistent Hyperinsulinemic Hypoglycemia of Infancy Is Specific of Focal Adenomatous Hyperplasia and Endorses Partial Pancreatectomy
		Sporadic persistent hyperinsulinemic hypoglycemia of infancy (PHHI) or nesidioblastosis is a heterogeneous disorder characterized
	www.jci.org /cgi/content/abstract/100/4/802 (1238 words)

	Open Directory - Health: Conditions and Diseases: Endocrine Disorders: Pancreas: Hypoglycemia (Site not responding. Last check: 2007-11-03)
		Children with PHHI - A discussion forum for parents with children who suffer from the genetic disorder persistant hyperinsulinemic-hypoglycemia of infancy, which used to be known as nesidioblastosis.
		Congenital Hyperinsulinism Center - Information for parents of children with congenital hyperinsulinism (nesidioblastosis or persistent hyperinsulinemic hypoglycemia of infancy), a disorder that causes low blood sugar.
		Hypoglycemia Forum - Provides sufferers and their family members with information and support.
	dmoz.org /Health/Conditions_and_Diseases/Endocrine_Disorders/Pancreas/Hypoglycemia (273 words)

	Persistent hyperinsulinemic hypoglycemia of infancy (Site not responding. Last check: 2007-11-03)
		Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is the most common cause of hypoglycemia in early infancy.
		The inappropriate oversecretion of insulin by the endocrine pancreas is responsible for profound hypoglycemia, which requires aggressive medical and/or surgical treatment to prevent severe and irreversible brain damage.
		First-line therapy consists of diazoxide, but the majority of newborns are resistant to it and to other treatments (e.g., the somatostatin analog octreotide, nifedipine, leucine-restricted diet).
	www.orpha.net /static/GB/persistent_hyperinsulinemic_hypoglycemia_of_infancy.html (167 words)

	[No title] (Site not responding. Last check: 2007-11-03)
		A trial of IV/oral glucose, frequent carbohydrate rich feeds in all, oral diazoxide (10 to 20 mg/kg) in 9/13 cases along with subcutaneous octreotide (20 mg/kg QID) in one helped, but pancreatic resection (85 to 90%) was opted for in two (1 familial, 1 sporadic).
		Of the seven survivors, one familial case with pancreatic resection is brain damaged, and of the six on diazoxide therapy, one is slightly subnormal while one sporadic and three familial cases have done well.
		The mortality (46%) and morbidity (43%) in survivors is high and calls for greater awareness, early diagnosis and genetic counselling, as this disorder may be familial.
	www.indianpediatrics.net /april2.htm (405 words)

	Neurologic Outcomes of 90 Neonates and Infants With Persistent Hyperinsulinemic Hypoglycemia -- Menni et al. 107 (3): ... (Site not responding. Last check: 2007-11-03)
		To evaluate the neurologic outcomes of neonates and infants suffering from persistent hyperinsulinemic hypoglycemia of infancy
		Neonatal hyperinsulinemic hypoglycemia is still a severe disease with an important risk to rapidly develop severe mental retardation
		Thomas PM, Cote GJ, Wohllk N, Mutations in the sulfonylurea receptor gene in familial persistent hyperinsulinemic hypoglycemia of infancy.
	pediatrics.aappublications.org /cgi/content/full/107/3/476 (2737 words)

	Diabetes In A Nonpancreatectomized Child With Nesidioblastosis -- Bin-Abbas and Al-Ashwal 27 (2): 626 -- Diabetes Care
		Leibowitz G, Glaser B, Higazi AA, Salameh M, Cerasi E, Landau H: Hyperinsulinemic hypoglycemia of infancy (nesidioblastosis) in clinical remission: high incidence of diabetes mellitus and persistent beta-cell dysfunction at long term follow-up.
		Tuoati G, Poggi-Travert F, Ogier de Baulny H, Rahier J, Brunelle F, Nihoul-Fekete C, Czernichow P, Saudubray JM: Long-term treatment of persistent hyperinsulinemic hypoglycemia of infancy with diazoxide: a retrospective review of 77 cases and analysis of efficacy-predicting criteria.
		Glaser B, Landaw H: Long-term treatment with somatostatin analogue SMS 201–995: alternative to pancreatectomy in persistent hyperinsulinemic hypoglycemia of infancy.
	care.diabetesjournals.org /cgi/content/full/27/2/626 (1065 words)

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