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Idiopathic postprandial hyperinsulinaemic hypoglycaemia

Maria Güemes, Maria Melikyan, Senthil Senniappan

    Journal of Pediatric Endocrinology & Metabolism : JPEM
    |May 27, 2016
    PubMed

    Insights

    Idiopathic postprandial hyperinsulinaemic hypoglycaemia (PPHH) in children is rare. Diagnosis requires a prolonged oral glucose tolerance test (OGTT), and while acarbose shows promise, frequent feeding alone is insufficient for management.

    Area of Science:

    • Pediatric Endocrinology
    • Metabolic Disorders
    • Clinical Research

    Background:

    • Idiopathic postprandial hyperinsulinaemic hypoglycaemia (PPHH) is infrequently documented in pediatric populations.
    • This study focuses on characterizing PPHH in children, including its clinical presentation, diagnostic approaches, and therapeutic strategies.

    Purpose of the Study:

    • To describe the clinical features, diagnostic methods, and management outcomes of pediatric patients diagnosed with PPHH.
    • To evaluate the efficacy of prolonged oral glucose tolerance tests (OGTT) in diagnosing PPHH in children.

    Main Methods:

    • A cohort of six pediatric patients with PPHH was studied at a single tertiary center.
    • Diagnostic tools included 24-hour blood glucose monitoring, diagnostic fasting tests, and prolonged oral glucose tolerance tests (OGTT) or mixed meal (MM) tests.

    Main Results:

    • All patients exhibited symptomatic hypoglycemia after 120 minutes during prolonged OGTT, accompanied by detectable serum insulin levels.
    • Acarbose demonstrated efficacy in glycemic and symptom control for some patients but was limited by side effects; diazoxide was beneficial in one case.
    • Management with frequent feeds alone did not resolve hypoglycemia during prolonged OGTT/MM tests.

    Conclusions:

    • Prolonged OGTT is essential for diagnosing PPHH in pediatric cases.
    • Acarbose can be beneficial for PPHH in children, though tolerance may be an issue.
    • The etiology of PPHH in the studied pediatric cohort remains undetermined.
    Abstract

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