Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA,
Horm Res Paediatr. 2024;97(2):187-194. doi: 10.1159/000531251. Epub 2023 Jul 14.
Hyperinsulinemic hypoglycemia is the most common cause of persistent hypoglycemia in children and adults. In adolescents and adults, hyperinsulinemic hypoglycemia is most frequently caused by an insulin-producing tumor.
A 17-year-old, previously healthy male presented with recurrent and severe episodes of hypoglycemia. Diagnostic evaluation was consistent with hyperinsulinemic hypoglycemia, and an insulinoma was suspected. Multiple imaging studies and surgical exploration failed to identify a lesion. Over the course of months, the patient was found to be refractory to conventional medical interventions.
Upon approval from the US Food and Drug Administration and the Institutional Review Board, the patient was treated with dasiglucagon, a novel soluble glucagon analog, under a single-patient Investigational New Drug. The patient has tolerated the medication and has been able to achieve appropriate glycemic control.
高胰岛素血症性低血糖是儿童和成人持续性低血糖的最常见原因。在青少年和成年人中,高胰岛素血症性低血糖最常由产生胰岛素的肿瘤引起。
一名 17 岁、既往健康的男性出现反复严重低血糖发作。诊断评估符合高胰岛素血症性低血糖,怀疑为胰岛素瘤。多项影像学研究和手术探查均未能发现病灶。数月来,患者对常规药物干预措施无反应。
在美国食品和药物管理局和机构审查委员会批准后,该患者在一项单患者新药临床试验中接受了新型可溶性胰高血糖素类似物——地特胰岛素治疗。该患者耐受了该药物治疗,并能够实现适当的血糖控制。