Complexities in the medical management of hypoglycaemia due to congenital hyperinsulinism

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Christopher Worth
  • Daphne Yau
  • Maria Salomon Estebanez
  • Elaine O’shea
  • Indraneel Banerjee

Abstract

Congenital Hyperinsulinism (CHI) is a rare disease of hypoglycaemia but is the most common form of recurrent and severe hypoglycaemia causing brain injury and neurodisability in children. The management of CHI is complex due to the limited choice of medications, all with a limited therapeutic window, often lacking efficacy and associated with serious side effects. The therapeutic strategy in CHI is to recognize and treat hypoglycaemia promptly, thereby optimizing long‐term neurological outcomes; this should be achieved through individualized treatment plans that deliver glycaemic stability while minimizing side effects. Further, such a strategy should consider the likelihood of reduction in disease severity over time, with dose adjustments and medication withdrawal as indicated to optimize both safety and tolerability. The option for pancreatic surgery should also be considered in specific circumstances as appropriate for the patient's best long‐term interests.

Bibliographical metadata

Original languageEnglish
JournalClinical Endocrinology
Early online date9 Jan 2020
DOIs
Publication statusPublished - 2020