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- December 1, 2008 |
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"Hypoglycemic Disorders: Investigation and Treatment"Dr. Amir Hanna (biography)
English - 2003-10-31 - 20 minutes
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 | (26 slides) |
Summary :
Fasting hypoglycemia can have a variety of underlying causes and so once the hypoglycemia has been clinically confirmed, the next step is to use the process of elimination to rule out different causes one by one, starting with the most obvious, for example drugs or critical illness.
In some cases, endogenous hyperinsulinemia is indicated based on plasma glucose response to glucagon, and plasma beta-hydroxybutyrate level following a prolonged fast (1). If insulinomas are suspected, their localization and treatment follows, for which there are recommended techniques and medications that will be discussed here.
Copyright © 2003 E-MedHosting.com Inc
Learning objectives :
The participant will learn how to detect the underlying cause of fasting hypoglycemia and how to detect and treat endogenous hyperinsulinemia.
Summary:
Hypoglycemia is a symptom
Look for an underlying cause
Fulfill Whipple's triad (atypical symptoms)
Rule out:
- Drugs
- Critical illness
- Hormonal deficiency
- Non-beta cell tumor
72-hour fast: to clarify different causes of hyperinsulinemia
Localize insulinoma when suspected
Surgery: treatment of choice for insulinoma
De-bulking surgery in malignant insulinoma
Medical treatment:
- Preparation for surgery
- Failed surgery
- Malignant insulinoma
Bibliographic references :
1. O'Brien T, O'Brien PC, Service FJ. “Insulin surrogates in insulinoma.”
J Clin Endocrinol Metab. 1993 Aug;77(2):448-51.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8345050&dopt=Abstract
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