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Management of the Child with Persistent Hypoglycemia After Surgery

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Congenital Hyperinsulinism

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Most children with focal hyperinsulinism are cured after surgical excision of the lesion; however, almost half of children with diffuse hyperinsulinism have persistent hypoglycemia after near-total pancreatectomy. A comprehensive assessment of the glycemic status should be undertaken once the patient is on a stable feeding regimen for several days. This assessment includes performing a Cure Fast to demonstrate the resolution of hyperinsulinism in children with focal hyperinsulinism, evaluation for the possibility of post-pancreatectomy diabetes after near-total pancreatectomy, and assessment for persistent hypoglycemia in children with diffuse hyperinsulinism. Treatment of persistent hyperinsulinism following pancreatectomy requires an individualized approach and often requires a combination of therapies to achieve a suitable regimen that can safely and reasonably be carried out at home.

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Authors and Affiliations

  1. Division of Endocrinology and Diabetes, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Amanda M. Ackermann & Diva D. De León-Crutchlow

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  1. Amanda M. Ackermann
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  2. Diva D. De León-Crutchlow
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Correspondence to Diva D. De León-Crutchlow .

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Editors and Affiliations

  1. Division of Endocrinology and Diabetes, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Diva D. De León-Crutchlow

  2. Division of Endocrinology and Diabetes, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania and The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Charles A. Stanley

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Ackermann, A.M., De León-Crutchlow, D.D. (2019). Management of the Child with Persistent Hypoglycemia After Surgery. In: De León-Crutchlow, D., Stanley, C. (eds) Congenital Hyperinsulinism. Contemporary Endocrinology. Humana Press, Cham. https://doi.org/10.1007/978-3-030-02961-6_11

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  • DOI: https://doi.org/10.1007/978-3-030-02961-6_11

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-030-02960-9

  • Online ISBN: 978-3-030-02961-6

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