Feeding Problems Are Persistent in Children with Severe Congenital Hyperinsulinism

Area of Science:

• Pediatrics
• Endocrinology
• Gastroenterology

Background:

• Congenital hyperinsulinism (CHI) is a rare pediatric endocrine disorder causing severe hypoglycemia.
• Feeding problems (FPs) complicate glucose management in CHI patients, hindering enteral intake.
• Systematic characterization of FPs in CHI follow-up is lacking.

Purpose of the Study:

• To determine the prevalence, types, and persistence of FPs in children with CHI.
• To investigate potential causal factors associated with FPs in CHI.

Main Methods:

• An observational study of 83 children with CHI in a specialized treatment center.
• FPs defined as difficulties with sucking, swallowing, vomiting, or food refusal.
• Prevalence of FPs assessed at diagnosis, 6, and 12 months post-diagnosis; genetic and severity markers analyzed.

Main Results:

• A third of CHI patients (28/83) experienced FPs, often requiring medication or tube feeding.
• Sucking/swallowing issues were early, while vomiting and food refusal persisted up to 12 months.
• Severe hypoglycemia at diagnosis and diffuse CHI with pancreatectomy correlated with higher FP rates.

Conclusions:

• FPs are common in children with CHI, impacting a significant proportion.
• Severe hyperinsulinism, particularly persistent forms, is the primary driver of FPs.
• Management strategies should address the underlying severity of CHI to mitigate FPs.