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Ketotic Hypoglycemia in Children with Previous Transient Congenital Hyperinsulinism

Prashant Patil1, Dinesh Giri1, Mohammed Didi1

  • 1Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK.

Indian Pediatrics
|March 6, 2018
PubMed

Insights

Transient Congenital Hyperinsulinism (CHI) can lead to ketotic hypoglycemia (KH) later in childhood. This study observed KH in children after their CHI resolved, highlighting a potential risk.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Neonatal Medicine

Background:

  • Congenital Hyperinsulinism (CHI) is a primary cause of neonatal hypoglycemia, typically non-ketotic.
  • Transient CHI resolves over time, but its long-term metabolic sequelae are not fully understood.

Observation:

  • Five children with transient CHI were monitored for subsequent metabolic complications.
  • Four of these children required diazoxide treatment for persistent hypoglycemia during the CHI phase.

Findings:

  • Ketotic hypoglycemia (KH) developed in all 5 children after their transient CHI resolved.
  • KH onset occurred an average of 6.7 months post-CHI resolution, at a mean age of 11.25 months.
  • Diazoxide was discontinued in four children, with KH emerging subsequently.

Implications:

  • Transient CHI may predispose children to developing ketotic hypoglycemia later.
  • Ongoing metabolic monitoring is crucial for children with a history of transient CHI.
  • This finding necessitates further research into the mechanisms linking transient CHI and later KH.

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