Startseite Postprandial hyperinsulinemic hypoglycemia in a child as a late complication of esophageal reconstruction
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Postprandial hyperinsulinemic hypoglycemia in a child as a late complication of esophageal reconstruction

  • Rade Vukovic ORCID logo EMAIL logo , Tatjana Milenkovic , Maja Djordjevic , Katarina Mitrovic , Sladjana Todorovic , Adrijan Sarajlija und Khalid Hussain
Veröffentlicht/Copyright: 24. Juni 2017

Abstract

Background:

Postprandial hyperinsulinemic hypoglycemia (PHH) is an increasingly recognized complication of gastric bypass surgery in obese adults, distinct from the “dumping syndrome”.

Case presentation:

Upon birth, primary repair of esophageal atresia was performed, and at the age of 14 months definite esophageal reconstruction was performed. At the age of 3 years, recurrent brief episodes of symptomatic hypoglycemia started. At the age of 5.7 years the girl was admitted to our clinic and investigations indicated hyperinsulinemic hypoglycemia. Oral glucose tolerance test (OGTT) and continuous glucose monitoring results revealed frequent postprandial hypoglycemic events, which were always preceded by early postprandial hyperglycemia. It was concluded that the patient had PHH caused by a delayed and hyperinsulinemic response to carbohydrate intake as a result of esophagogastric surgery. Treatment with acarbose was titrated using flash glucose monitoring, which resulted in satisfactory glucose regulation.

Conclusions:

This is the first described case of a child with PHH following esophageal reconstruction.


Corresponding author: Rade Vukovic, MD, PhD, Department of Endocrinology, Mother and Child Health Care Institute of Serbia “Dr Vukan Cupic”, Radoja Dakica 8, 11070 Belgrade, Serbia, Phone: +381113108193, Fax: +381113108257

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2017-4-6
Accepted: 2017-6-2
Published Online: 2017-6-24
Published in Print: 2017-7-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

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