Plasma C peptide in hyperinsulinaemic hypoglycaemia

Area of Science:

• Pediatric Endocrinology
• Metabolic Disorders
• Clinical Diagnostics

Background:

• Hypoglycaemia in children can stem from various causes, including endocrine and metabolic dysfunctions.
• Pancreatic beta cell hyperactivity is a significant, though less common, etiology of persistent hypoglycaemia.
• Accurate diagnosis is crucial for timely and appropriate management to prevent neurological sequelae.

Observation:

• Two pediatric cases presented with symptomatic hypoglycaemia.
• Despite low serum insulin levels, both patients exhibited elevated plasma C-peptide concentrations during hypoglycaemic episodes.
• These clinical and biochemical findings suggested endogenous hyperinsulinism.

Findings:

• The observed pattern of low insulin and high C-peptide is characteristic of excessive insulin production by pancreatic beta cells.
• C-peptide measurement proved instrumental in differentiating this condition from exogenous insulin administration or other causes of low insulin.
• This highlights the diagnostic utility of C-peptide in evaluating hyperinsulinaemic hypoglycaemia.

Implications:

• Measuring C-peptide is a valuable diagnostic tool for identifying hyperinsulinaemic hypoglycaemia in pediatric patients.
• Early and accurate diagnosis facilitates targeted therapeutic interventions for pancreatic beta cell hyperactivity.
• Understanding these biochemical markers improves the management of complex hypoglycaemic disorders in children.