Glucose Metabolism in 105 Children and Adolescents After Pancreatectomy for Congenital Hyperinsulinism
| العنوان: | Glucose Metabolism in 105 Children and Adolescents After Pancreatectomy for Congenital Hyperinsulinism |
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| المؤلفون: | Jacques Rahier, Jacques Beltrand, Jean-Baptiste Arnoux, Francis Brunelle, Jean-Jacques Robert, Marylène Caquard, Virginie Verkarre, Jean-Marie Saudubray, Kathleen Laborde, Claire Nihoul-Fékété, Gilberto Velho, Pascale de Lonlay |
| المساهمون: | UCL - (SLuc) Service d'anatomie pathologique |
| المصدر: | Diabetes Care Diabetes Care, Vol. 35, no. 2, p. 198-203 (2012) |
| بيانات النشر: | American Diabetes Association, 2012. |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | Blood Glucose, Male, medicine.medical_specialty, Adolescent, endocrine system diseases, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, Kaplan-Meier Estimate, Hypoglycemia, Gastroenterology, 03 medical and health sciences, Pancreatectomy, 0302 clinical medicine, 030225 pediatrics, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Hyperinsulinemia, Humans, Insulin, Cumulative incidence, Child, Original Research, Advanced and Specialized Nursing, business.industry, Infant, Newborn, Clinical Care/Education/Nutrition/Psychosocial Research, Infant, nutritional and metabolic diseases, medicine.disease, 3. Good health, Surgery, Treatment Outcome, Postprandial, Child, Preschool, Congenital hyperinsulinism, Congenital Hyperinsulinism, Female, business, Follow-Up Studies |
| الوصف: | OBJECTIVE To describe the long-term metabolic outcome of children with congenital hyperinsulinism after near-total or partial elective pancreatectomy. RESEARCH DESIGN AND METHODS Patients (n = 105: 58 diffuse and 47 focal congenital hyperinsulinism) received operations between 1984 and 2006. Follow-up consisted of periodic measurements of pre- and postprandial plasma glucose over 24 h, OGTT, and IVGTT. Cumulative incidence of hypo- or hyperglycemia/insulin treatment was estimated by Kaplan-Meier analysis. RESULTS After near-total pancreatectomy, 59% of children with diffuse congenital hyperinsulinism still presented mild or asymptomatic hypoglycemia that responded to medical treatments and disappeared within 5 years. One-third of the patients had both preprandial hypoglycemia and postprandial hyperglycemia. Hyperglycemia was found in 53% of the patients immediately after surgery; its incidence increased regularly to 100% at 13 years. The cumulative incidence of insulin-treated patients was 42% at 8 years and reached 91% at 14 years, but the progression to insulin dependence was very variable among the patients. Plasma insulin responses to IVGTT and OGTT correlated well with glycemic alterations. In focal congenital hyperinsulinism, hypoglycemia or hyperglycemia were rare, mild, and transient. CONCLUSIONS Patients with focal congenital hyperinsulinism are cured of hypoglycemia after limited surgery, while the outcome of diffuse congenital hyperinsulinism is very variable after near-total pancreatectomy. The incidence of insulin-dependent diabetes is very high in early adolescence. |
| تدمد: | 1935-5548 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::aa48a09c8b20c2d44d3d58cc15603ffdTest https://doi.org/10.2337/dc11-1296Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....aa48a09c8b20c2d44d3d58cc15603ffd |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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