Abstract | CONTEXT: OBJECTIVE: The objective was to determine the prevalence of diabetes and neurobehavioral deficits in surgically treated HI. DESIGN: This was designed as a cross-sectional study of individuals who underwent pancreatectomy for HI between 1960 and 2008. OUTCOMES: Diabetes outcomes were assessed through patient interview and medical record review. Neurobehavioral outcomes were assessed through the Adaptive Behavior Assessment System, 2nd edition (ABAS-II), and the Child Behavior Checklist (CBCL). RESULTS: A total of 121 subjects were enrolled in the study at a median age of 8.9 years (range, 3.5-50.7 y). Thirty-six percent (44 of 121) of subjects had diabetes. Nine subjects developed diabetes immediately after pancreatectomy. Of the remaining 35 subjects who developed diabetes, the median age at diabetes diagnosis was 7.7 years (range, 8 mo to 43 y). In subjects with diabetes, the median hemoglobin A1c was 7.4% (range, 6.5-12.6%), and 38 (86%) subjects required insulin. Subjects with diabetes had a greater percentage of pancreatectomy than subjects without diabetes (95% [range, 65-98] vs 65% [1-98]). Neurobehavioral abnormalities were reported in 58 (48%) subjects. Nineteen (28%) subjects had abnormal ABAS-II scores, and 10 (16%) subjects had abnormal CBCL scores. CONCLUSIONS: Children, who undergo near-total pancreatectomy are at high risk of developing diabetes. Neurobehavioral deficits are common, and developmental assessment is essential for children with HI.
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Authors | Katherine Lord, Jerilynn Radcliffe, Paul R Gallagher, N Scott Adzick, Charles A Stanley, Diva D De León |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 100
Issue 11
Pg. 4133-9
(Nov 2015)
ISSN: 1945-7197 [Electronic] United States |
PMID | 26327482
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
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Chemical References |
- Glycated Hemoglobin A
- Hypoglycemic Agents
- Insulin
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Topics |
- Adolescent
- Adult
- Age of Onset
- Child
- Child, Preschool
- Cognition Disorders
(etiology, psychology)
- Congenital Hyperinsulinism
(complications, psychology, surgery)
- Cross-Sectional Studies
- Diabetes Mellitus
(etiology, physiopathology, psychology)
- Female
- Glycated Hemoglobin
(analysis)
- Humans
- Hypoglycemic Agents
(therapeutic use)
- Insulin
(therapeutic use)
- Male
- Middle Aged
- Neuropsychological Tests
- Pancreatectomy
- Postoperative Complications
(physiopathology, psychology)
- Pregnancy
- Risk Factors
- Young Adult
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