Hypoglycemia of infancy and nesidioblastosis. Studies with somatostatin.

Abstract

We treated a two-month-old infant with servere intractable hypoglycemia and nesidioblastosis with continuous glucose infusions (0.75 g per kilogram per hour) via a central venous catheter. Preprandial glucose levels on this regimen were 37+/-2 mg per deciliter (+/-S.E.M.). Basal serum insulin levels were within normal fasting levels for this age group but inappropriately elevated for the blood glucose levels. The beta cells were exquisitely sensitive to infusions of synthetic cyclic somatostatin, with a dose-dependent rise in blood glucose and concomitant suppression of serum insulin levels. There was only minimal suppression of plasma glucagon levels. Single subcutaneous injections of 50 microng of protamine zinc somatostatin raised preprandial blood glucose levels to 83+/-3 mg per deciliter for four to five days although preprandial hormone levels were unchanged. These findings indicate that hypoglycemia of infancy is a hyperinsulin state with abnormal basal regulation of insulin secretion.

• Authors: H J Hirsch, S Loo, N Evans, J F Crigler, R M Filler, K H Gabbay
• Journal: The New England journal of medicine (N Engl J Med) Vol. 296 Issue 23 Pg. 1323-6 (Jun 09 1977) ISSN: 0028-4793 [Print] United States
• PMID: 193007 (Publication Type: Case Reports, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Blood Glucose
• Insulin
• Somatostatin
• Glucagon

Topics

• Adenoma, Islet Cell (complications, physiopathology)
• Age Factors
• Blood Glucose (analysis)
• Dose-Response Relationship, Drug
• Female
• Glucagon (metabolism)
• Humans
• Hypoglycemia (etiology, physiopathology)
• Infant
• Insulin (metabolism)
• Insulin Secretion
• Pancreatic Neoplasms (complications, physiopathology)
• Somatostatin (administration & dosage, pharmacology)
• Stimulation, Chemical