Persistent Hyperinsulinemic Hypoglycemia in Iraqi Pediatric Population: A Single Tertiary Center Experience

Background: Congenital hyperinsulinism (CHI) is an inappropriate insulin secretion by the pancreatic cells. When medical therapies are ineffective, surgical treatment is required. Objective: This study aims to evaluate the clinical characteristics of CHI patients and assess the associated factors th...

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Main Authors: Munib Ahmed Al-Zubaidi, Wasnaa Hadi Abdullah, Khalid Hatem Kareem
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Medical Journal of Babylon
Subjects:
Online Access:https://doi.org/10.4103/MJBL.MJBL_1144_23
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author Munib Ahmed Al-Zubaidi
Wasnaa Hadi Abdullah
Khalid Hatem Kareem
author_facet Munib Ahmed Al-Zubaidi
Wasnaa Hadi Abdullah
Khalid Hatem Kareem
author_sort Munib Ahmed Al-Zubaidi
collection DOAJ
description Background: Congenital hyperinsulinism (CHI) is an inappropriate insulin secretion by the pancreatic cells. When medical therapies are ineffective, surgical treatment is required. Objective: This study aims to evaluate the clinical characteristics of CHI patients and assess the associated factors that may affect their response to treatment. Materials and Methods: This is a retrospective study including all patients diagnosed with hyperinsulinemic hypoglycemia who were registered at the Children Welfare Teaching Hospital in Baghdad, Iraq. Patients’ data were collected including birth weight, age at presentation, and consanguinity between parents. All patients had a confirmed diagnosis of hyperinsulinism after performing a critical sample. The data of these investigations were collected in addition to the type of medical treatment they received and those who had finally undergone pancreatectomy. Results: Among the 44 patients in the study, 38 (86.4%) presented in the first year of life. Of these, 22 (57.9%) were responsive to diazoxide. In addition, 13 (34.2%) of those presenting in the first year required pancreatectomy. Among the remaining six patients who presented after the first year of life, three (50%) responded to diazoxide, while two (33.3%) required pancreatectomy. Patients who did not respond to diazoxide had higher mean insulin and age at presentation with 19.58 ± 17.28 µU/ml and 9.73 ± 28.23 months, respectively. Conclusion: While genetic study remains the gold standard for the diagnosis of CHI, clinical characteristics of patients can be the only helpful way to predict further management in countries with limited resources.
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spelling doaj-art-c659a3d0d8194a509034dbf7ba8d30f52025-01-17T10:54:56ZengWolters Kluwer Medknow PublicationsMedical Journal of Babylon1812-156X2312-67602024-12-0121497598110.4103/MJBL.MJBL_1144_23Persistent Hyperinsulinemic Hypoglycemia in Iraqi Pediatric Population: A Single Tertiary Center ExperienceMunib Ahmed Al-ZubaidiWasnaa Hadi AbdullahKhalid Hatem KareemBackground: Congenital hyperinsulinism (CHI) is an inappropriate insulin secretion by the pancreatic cells. When medical therapies are ineffective, surgical treatment is required. Objective: This study aims to evaluate the clinical characteristics of CHI patients and assess the associated factors that may affect their response to treatment. Materials and Methods: This is a retrospective study including all patients diagnosed with hyperinsulinemic hypoglycemia who were registered at the Children Welfare Teaching Hospital in Baghdad, Iraq. Patients’ data were collected including birth weight, age at presentation, and consanguinity between parents. All patients had a confirmed diagnosis of hyperinsulinism after performing a critical sample. The data of these investigations were collected in addition to the type of medical treatment they received and those who had finally undergone pancreatectomy. Results: Among the 44 patients in the study, 38 (86.4%) presented in the first year of life. Of these, 22 (57.9%) were responsive to diazoxide. In addition, 13 (34.2%) of those presenting in the first year required pancreatectomy. Among the remaining six patients who presented after the first year of life, three (50%) responded to diazoxide, while two (33.3%) required pancreatectomy. Patients who did not respond to diazoxide had higher mean insulin and age at presentation with 19.58 ± 17.28 µU/ml and 9.73 ± 28.23 months, respectively. Conclusion: While genetic study remains the gold standard for the diagnosis of CHI, clinical characteristics of patients can be the only helpful way to predict further management in countries with limited resources.https://doi.org/10.4103/MJBL.MJBL_1144_23diazoxidehyperinsulinismhypoglycemiapancreatectomy
spellingShingle Munib Ahmed Al-Zubaidi
Wasnaa Hadi Abdullah
Khalid Hatem Kareem
Persistent Hyperinsulinemic Hypoglycemia in Iraqi Pediatric Population: A Single Tertiary Center Experience
Medical Journal of Babylon
diazoxide
hyperinsulinism
hypoglycemia
pancreatectomy
title Persistent Hyperinsulinemic Hypoglycemia in Iraqi Pediatric Population: A Single Tertiary Center Experience
title_full Persistent Hyperinsulinemic Hypoglycemia in Iraqi Pediatric Population: A Single Tertiary Center Experience
title_fullStr Persistent Hyperinsulinemic Hypoglycemia in Iraqi Pediatric Population: A Single Tertiary Center Experience
title_full_unstemmed Persistent Hyperinsulinemic Hypoglycemia in Iraqi Pediatric Population: A Single Tertiary Center Experience
title_short Persistent Hyperinsulinemic Hypoglycemia in Iraqi Pediatric Population: A Single Tertiary Center Experience
title_sort persistent hyperinsulinemic hypoglycemia in iraqi pediatric population a single tertiary center experience
topic diazoxide
hyperinsulinism
hypoglycemia
pancreatectomy
url https://doi.org/10.4103/MJBL.MJBL_1144_23
work_keys_str_mv AT munibahmedalzubaidi persistenthyperinsulinemichypoglycemiainiraqipediatricpopulationasingletertiarycenterexperience
AT wasnaahadiabdullah persistenthyperinsulinemichypoglycemiainiraqipediatricpopulationasingletertiarycenterexperience
AT khalidhatemkareem persistenthyperinsulinemichypoglycemiainiraqipediatricpopulationasingletertiarycenterexperience