Abstract
SS, an inhibitor of insulin (I) secretion, has been reported to reduce glucose requirements and thus facilitate the treatment of hypoglycemia associated with HI in infancy. In addition,while I levels have been shown to affect IB and IB is an important determinant of I action, the effect of HI on IB in infants has not been determined. We therefore examined the effect of varying doses of SS on glucose regulation and IB before and after chronic I suppression in a 15 mo. old boy with HI. Low dose SS (2 μg/kg/min) promptly reduced plasma I (30-35%) and increased plasma glucose (22 to 80 mg%) but failed to maintain euglycemia without glucose administration. When SS was increased (8 μg/kg/min), normal plasma glucose was maintained despite withdrawal of exogenous glucose. IB to monocytes was determined before and 4 wks following suppression of excessive I secretion with diazoxide. Pre-Rx IB was markedly reduced (1.2%) as compared to normal control children (7.0 ± 0.3%,N=6). Post-Rx IB increased 300% in association with a reduction of basal I from 38 to 7 μU/ml. These data provide further evidence for the potential therapeutic efficacy of SS in HI but emphasizes the need for individualization of dosage. Furthermore, IB was inversely related to I levels in our patient as seen in other hyperinsulinemic states in adults. These changes in IB may serve as a protective compensatory response and could prove useful in the diagnosis of HI.
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Tamborlane, W., Soman, V., Sherwln, R. et al. 898 HYPERINSULINISM(HI)IN INFANCY: EFFECT OF SOMATOSTATIN (SS) ADMINISTRATION AND ALTERATIONS IN INSULIN BINDING (IB) TO MONOCYTES. Pediatr Res 12 (Suppl 4), 513 (1978). https://doi.org/10.1203/00006450-197804001-00903
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DOI: https://doi.org/10.1203/00006450-197804001-00903