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Hypoglycemia and Glucagon

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...

Hypoglycemia

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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...

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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...

Hyperglycemia

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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...

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Type 1 diabetes mellitus is a chronic metabolic disorder characterized by an absolute deficiency of insulin resulting from the autoimmune destruction of pancreatic β-cells. Although it can occur at any age, it is most commonly diagnosed in childhood, adolescence, or early adulthood. The loss of insulin production impairs cellular glucose uptake, resulting in persistent hyperglycemia and necessitating lifelong insulin therapy.Autoimmune Destruction of β-CellsThe hallmark of type 1 diabetes is an...

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Updated: May 19, 2026

Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice

Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice

Published on: November 16, 2011

Persistent hyperinsulinemic hypoglycemia of infancy.

Dinesh Yadav¹, Bhavna Dhingra, Sandeep Kumar

¹Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India. dineshmamc@gmail.com

Journal of Pediatric Endocrinology & Metabolism : JPEM

|August 11, 2012

Summary

This summary is machine-generated.

Congenital hyperinsulinism (CHI), a cause of infant hypoglycemia, was diagnosed using a 68Ga octreotide PET scan. Genetic analysis and surgery led to a successful outcome, with the infant remaining asymptomatic.

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Published on: November 16, 2011

Improving IV Insulin Administration in a Community Hospital

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Published on: November 13, 2016

Area of Science:

Pediatric Endocrinology
Nuclear Medicine
Medical Genetics

Background:

Congenital hyperinsulinism (CHI) is a significant cause of persistent hypoglycemia in infants and children.
Accurate preoperative diagnosis is crucial for effective management and surgical planning.

Observation:

A case of CHI presented with diffuse pancreatic abnormality.
The 68Ga octreotide (DOTA NOC) positron emission tomography scan provided precise preoperative localization.
Genetic analysis identified a homozygous ABCC8 splicing mutation.

Findings:

The 68Ga octreotide PET scan successfully diagnosed CHI with diffuse pancreatic involvement.
Genetic confirmation of an ABCC8 mutation supported the diagnosis.
A subtotal pancreatectomy (95%) resulted in sustained euglycemia.

Implications:

68Ga octreotide PET scanning is a valuable tool for diagnosing CHI, especially diffuse forms.
Genetic analysis aids in understanding the underlying mechanisms of CHI.
Surgical intervention can effectively manage CHI, leading to long-term positive outcomes.