Hyperinsulinism as a common cause of hypoglycemia in children - pathogenesis, diagnosis and treatment.

Hypoglycemia is a heterogenic metabolic syndrome with the complicated pathogenesis, diagnosis and treatment. It comprises a broad spectrum of disorders and requires multidisciplinary assessment including pediatrics, endocrinology and diabetology, metabolic medicine and genetics. There are various classifications of hypoglycemia. Commonly it is divided into fasting and postprandial hypoglycemia with or without hyperinsulinemia. Congenital hyperinsulinism (HI) is the commonest cause of severe hypoglycemia in a newborn period. There are many different genetic mutations causing inappropriate insulin secretion. The type of genetic mutation determines diagnostic pathway and management of hyperinsulinemic hypoglycemia. Since recurrent hypoglycemia may cause a serious brain damage in children, it is essential to properly diagnose affected children in order to prevent further attacks of hypoglycemia.