改性玉米粉作为胰岛素瘤引起的低血糖症的有效治疗方法:一个案例报告
Karen Castillo1, Aida Orois2, Diego Duminy-Luppi3
1Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain. KACASTILLO@clinic.cat.
European journal of clinical nutrition
|March 22, 2025
概括
在90岁的老人中,复发性低血糖症是通过修改的玉米粉和降低的氧化剂量的组合来管理的. 这种饮食和药理方法有效控制了血糖,没有副作用.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
背景情况:
- 反复出现的症状性低血糖症会显著影响生活质量,特别是在老年患者中.
- 内源性高胰岛素症虽然不常见,但需要彻底调查以确定潜在原因.
- 胰岛素瘤是一种罕见的胰腺神经内分泌瘤,是持续高胰岛素血糖低血症的主要考虑因素.
研究的目的:
- 描述因胰岛素瘤导致的复发性症状性低血糖症在非老年人的成功管理.
- 在被认为不适合进行手术的患者中评估联合饮食和药理治疗策略.
- 突出修改的玉米粉和持续的葡萄糖监测在管理高胰岛素低血糖的有效性.
主要方法:
- 诊断工作包括排除常见原因,确认内源性高胰岛素,并利用腹部CT和 (68) Ga-DOTA-TOC PET-CT用于病变定位.
- 一个多学科团队认为该患者不适合进行手术.
- 治疗包括初始的氧化物,其次是修改的玉米粉饮食 (Glycosade®),在持续的葡萄糖监测下分成剂量.
主要成果:
- 图像检查证实了胰腺尾部的15毫米胰岛素瘤.
- 氧化物治疗导致剂量限制的副作用.
- 综合的饮食和药理方法成功地预防了低血糖发作,允许降低二氧化剂量并避免进一步的并发症.
结论:
- 结合改性玉米和调整的药物治疗的保守管理方法可以在老年高风险患者中有效治疗因胰岛素瘤引起的低血糖症.
- 持续的葡萄糖监测对于优化饮食干预来管理复杂的葡萄糖失调至关重要.
- 患者的偏好和避免侵入性手术是治疗策略的关键因素.
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