Related Experiment Video

Updated: Aug 20, 2026

Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice
11:10

Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice

Published on: November 16, 2011

[Persistent hyperinsulinemic hypoglycemia. Two case reports]

Norberto Sotelo-Cruz1, Andrés Cordero-Olivares, Carlos Ramírez-Rodríguez

  • 1Servicio de Medicina Interna, Hospital Infantil del Estado de Sonora. nsotelo@hmo.megared.net.mx

Cirugia Y Cirujanos
|November 20, 2004
PubMed

Insights

Persistent hyperinsulinism (PHH) in infants causes seizures and hypoglycemia. A glucose/insulin ratio > 0.3 suggests surgery, like pancreatectomy, may be needed if medical treatments fail.

Area of Science:

  • Pediatric Endocrinology
  • Surgical Gastroenterology

Background:

  • Persistent hyperinsulinism (PHH) is a critical cause of recurrent hypoglycemia in infants.
  • Diagnosis can be challenging, often requiring specialized metabolic testing.

Observation:

  • Two infants presented with seizures and persistent hypoglycemia.
  • Initial diagnostic workup revealed a high glucose/insulin ratio (> 0.3) but no pancreatic abnormalities.
  • Medical management with hydrocortisone, diazoxide, and octreotide proved ineffective.

Findings:

  • Nesidioblastosis, characterized by islet cell changes, was confirmed histologically post-surgery.
  • Sub-total pancreatectomy was the definitive treatment for both cases.
  • Histologic findings confirmed nesidioblastosis in the Langerhans islets.

Implications:

  • A glucose/insulin ratio > 0.3 in infants with PHH is a strong indicator for surgical intervention.
  • Timely surgical treatment, such as pancreatectomy, should be considered to avoid delayed management.
  • This highlights the importance of surgical consideration in refractory PHH cases.

More Related Videos

Hyperglycemic Clamp and Hypoglycemic Clamp in Conscious Mice07:35

Hyperglycemic Clamp and Hypoglycemic Clamp in Conscious Mice

Published on: January 26, 2024

Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Type I Diabetes III: Clinical Manifestations01:19

Type I Diabetes III: Clinical Manifestations

Type 1 diabetes mellitus typically presents with rapid-onset symptoms due to the body’s inability to utilize glucose in the absence of insulin. Since insulin is required for glucose uptake into cells, its deficiency leads to hyperglycemia and cellular energy deprivation, resulting in characteristic clinical features.Polyuria and PolydipsiaOne of the earliest, most prominent symptoms is polyuria (excessive urination). When blood glucose concentrations rise above the renal threshold, the kidneys...
Hyperosmolar Hyperglycemic State01:21

Hyperosmolar Hyperglycemic State

Hyperosmolar Hyperglycemic State, or HHS, is a serious and life-threatening complication of type 2 diabetes mellitus. It is characterized by three main features: severe hyperglycemia, profound dehydration, and elevated serum osmolality, all occurring without significant ketoacidosis.HHS typically develops in older adults or individuals with limited access to fluids. This may result from illness, cognitive impairment, or medications such as diuretics or corticosteroids. These factors reduce...
Type II Diabetes II: Pathophysiology01:24

Type II Diabetes II: Pathophysiology

PathophysiologyType 2 diabetes mellitus (T2DM ) is a chronic metabolic disorder characterized by insulin resistance and progressive pancreatic β-cell dysfunction, leading to impaired glucose homeostasis. It results from interactions among genetic predisposition, environmental factors, and metabolic stressors, such as overnutrition and a sedentary lifestyle.Insulin Resistance and Glucose DysregulationEarly T2DM involves insulin resistance in skeletal muscle, adipose tissue, and the liver.