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Determination of insulin for the diagnosis of hyperinsulinemic hypoglycemia

Authors
Journal
Best Practice & Research Clinical Endocrinology & Metabolism
1521-690X
Publisher
Elsevier
Volume
27
Issue
6
Identifiers
DOI: 10.1016/j.beem.2013.06.005
Keywords
  • Hypoglycemia
  • Insulinoma
  • Hyperinsulinism
  • Beta Cells
  • Pancreas
Disciplines
  • Biology
  • Chemistry
  • Medicine

Abstract

Hyperinsulinemic hypoglycemia is the most common cause of persistent hypoglycemia in children and adults. The diagnosis of hyperinsulinemic hypoglycemia relies on the evaluation of the biochemical profile at the time of hypoglycemia, however, contrary to common perception, plasma insulin is not always elevated. Thus, the diagnosis must often be based on the examination of other physiologic manifestations of excessive insulin secretion, such as suppression of glycogenolysis, lipolysis and ketogenesis, which can be inferred by the finding of a glycemic response to glucagon, and the suppression of plasma free fatty acids and beta-hydroxybutyrate concentrations during hypoglycemia.

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