Role of Incretin Hormones in Hyperinsulinemic Hypoglycemia

2012 ◽  
pp. 79-86
Author(s):  
Diva D. De León
Keyword(s):  
Hyperinsulinemic Hypoglycemia ◽  
Incretin Hormones

scholarly journals 151 Role of diazoxide therapy in small for gestational age infants with prolonged hyperinsulinemic hypoglycemia

2021 ◽  
Author(s):  
Sandra Jaya-Bodestyne ◽  
Victor Samuel Rajadurai ◽  
Mohanambal Arumugham ◽  
Mei Chien Chua ◽  
Fabian Yap ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Hyperinsulinemic Hypoglycemia

scholarly journals Hyperinsulinemic Hypoglycemia After Roux-en-Y Gastric Bypass: Unraveling the Role of Gut Hormonal and Pancreatic Endocrine Dysfunction

2011 ◽  
Vol 167 (2) ◽  
pp. 199-205 ◽  
Author(s):  
Atoosa Rabiee ◽  
J. Trent Magruder ◽  
Rocio Salas-Carrillo ◽  
Olga Carlson ◽  
Josephine M. Egan ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Hyperinsulinemic Hypoglycemia ◽  
Endocrine Dysfunction

scholarly journals Diagnostic Evaluation of Hypoglycemia Due To an Insulinoma in a Deployed Infantryman: Significance of Neuroglycopenia and the Role of the Military Health System

2021 ◽  
Author(s):  
Samuel T Olatunbosun ◽  
Ayodeji F Alaketu ◽  
Joseph H McDermott ◽  
Al M Elsayed von Bayreuth
Keyword(s):  
Health System ◽  
Rare Condition ◽  
Service Member ◽  
Hyperinsulinemic Hypoglycemia ◽  
Suspected Case ◽  
Military Health System ◽  
Military Population ◽  
Military Health ◽  
The Military

ABSTRACT Insulinoma, the prototype of endogenous hyperinsulinemic hypoglycemia, is a very rare condition, with an incidence of four cases per million person-years. Its rate of occurrence in the U.S. military population is unknown. Two cases of insulinomas involving active duty service members have been published. However, there has been no reported case of an insulinoma in a deployed service member. We report the case of a 21-year-old infantryman with clinical hypoglycemia of insidious onset, manifesting with overt neuroglycopenic symptoms during his deployment as a combatant soldier, and the ultimate diagnosis of an insulinoma as the underlying cause. The series of multiple clinical evaluations and the unique circumstances leading to the formal evaluation of the patient’s hypoglycemia and treatment are chronicled. The significance of neuroglycopenia and the diagnostic approach to any suspected case of hypoglycemia, the potential challenges and opportunities, and educational aspects of evaluation and management of the insulinoma are elaborated. The potential role of the Military Health System in facilitating the detection and treatment of this rare condition in the service member is discussed as well.

scholarly journals Circulating acylghrelin levels are suppressed by insulin and increase in response to hypoglycemia in healthy adult volunteers

2015 ◽  
Vol 172 (4) ◽  
pp. 357-362 ◽  
Author(s):  
Esben S Lauritzen ◽  
Thomas Voss ◽  
Ulla Kampmann ◽  
Annette Mengel ◽  
Mikkel H Vendelbo ◽  
...  
Keyword(s):  
University Hospital ◽  
Saline Control ◽  
Hyperinsulinemic Hypoglycemia ◽  
Clinical Research Center ◽  
Acute Hypoglycemia ◽  
Bolus Insulin ◽  
Rebound Increase ◽  
Adult Volunteers ◽  
Circulating Levels

ObjectiveGhrelin has glucoregulatory and orexigenic actions, but its role in acute hypoglycemia remains uncertain. We aimed to investigate circulating levels of acylghrelin (AG) and unacylated ghrelin (UAG) in response to hyperinsulinemia and to hypoglycemia.DesignA randomized, single-blind, placebo-controlled crossover study including 3 study days was performed at a university hospital clinical research center.MethodsNine healthy men completed 3 study days: i) saline control (CTR), ii) hyperinsulinemic euglycemia (HE) (bolus insulin 0.1 IE/kg i.v. and glucose 20% i.v. for 105 min, plasma glucose ≈5 mmol/l), and iii) hyperinsulinemic hypoglycemia (HH) (bolus insulin 0.1 IE/kg i.v.).ResultsHH and HE suppressed AG concentrations at t=45–60 min as compared with CTR (P<0.05). At t=90 min, a rebound increase in AG was observed in response to HH as compared with both HE and CTR (P<0.05). UAG also decreased during HH and HE at t=45 min (P<0.05), whereas the AG-to-UAG ratio remained unaffected.ConclusionsThis study demonstrates that AG and UAG are directly suppressed by hyperinsulinemia and that AG concentrations increase after a latency of ≈1 h in response to hypoglycemia, suggesting a potential counterregulatory role of AG.

scholarly journals Maternal mosaicism for a missense variant in the SMS gene that causes Snyder-Robinson syndrome

2021 ◽  
pp. mcs.a006122
Author(s):  
Mohammad Marhabaie ◽  
Scott E Hickey ◽  
Katherine E Miller ◽  
Olivia Grischow ◽  
Kathleen M Schieffer ◽  
...  
Keyword(s):  
High Throughput Sequencing ◽  
De Novo ◽  
Genetic Disorders ◽  
Missense Variant ◽  
Hyperinsulinemic Hypoglycemia ◽  
Spermine Synthase ◽  
Genetic Mosaicism ◽  
The Family ◽  
Bilateral Sensorineural Hearing Loss

There is increasing recognition for the contribution of genetic mosaicism to human disease, particularly as high-throughput sequencing has enabled detection of sequence variants at very low allele frequencies. Here, we describe an infant male who presented at 9 months of age with hypotonia, dysmorphic features, congenital heart disease, hyperinsulinemic hypoglycemia, hypothyroidism, and bilateral sensorineural hearing loss. Whole-genome sequencing of the proband and the parents uncovered an apparent de novo mutation in the X-linked SMS gene. SMS encodes spermine synthase, which catalyzes the production of spermine from spermidine. Inactivation of the SMS gene disrupts the spermidine/spermine ratio, resulting in Snyder-Robinson syndrome. The variant in our patient is absent from the gnomAD and ExAC databases and causes a missense change (p.Arg130Cys) predicted to be damaging by most in silico tools. While Sanger sequencing confirmed the de novo status in our proband, PCR and deep targeted resequencing to ~84,000-175,000x depth revealed that the variant is present in blood from the unaffected mother at ~3% variant allele frequency. Our findings thus provided a long-sought diagnosis for the family while highlighting the role of parental mosaicism in severe genetic disorders.

scholarly journals Gut-Pancreas-Liver Axis as a Target for Treatment of NAFLD/NASH

2020 ◽  
Vol 21 (16) ◽  
pp. 5820
Author(s):  
Gianluca Svegliati-Baroni ◽  
Bárbara Patrício ◽  
Gessica Lioci ◽  
Maria Paula Macedo ◽  
Amalia Gastaldelli
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Incretin Hormones ◽  
Portal Circulation ◽  
Therapeutic Approaches ◽  
Alcoholic Fatty Liver ◽  
Obesity And Diabetes ◽  
Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) represents the most common form of chronic liver disease worldwide. Due to its association with obesity and diabetes and the fall in hepatitis C virus morbidity, cirrhosis in NAFLD is becoming the most frequent indication to liver transplantation, but the pathogenetic mechanisms are still not completely understood. The so-called gut-liver axis has gained enormous interest when data showed that its alteration can lead to NAFLD development and might favor the occurrence of non-alcoholic steatohepatitis (NASH). Moreover, several therapeutic approaches targeting the gut-pancreas-liver axis, e.g., incretins, showed promising results in NASH treatment. In this review, we describe the role of incretin hormones in NAFLD/NASH pathogenesis and treatment and how metagenomic/metabolomic alterations in the gut microbiota can lead to NASH in the presence of gut barrier modifications favoring the passage of bacteria or bacterial products in the portal circulation, i.e., bacterial translocation.

scholarly journals Postprandial hypoglycemia after upper gastrointestinal tract surgery: prevalence and pathophysiology (part 1)

2020 ◽  
Vol 49 ◽  
Author(s):  
M. Yu. Yukina ◽  
M. O. Chernova ◽  
E. A. Troshina ◽  
V. V. Evdoshenko ◽  
N. M. Platonova
Keyword(s):  
Bariatric Surgery ◽  
Hyperinsulinemic Hypoglycemia ◽  
Major Health Problem ◽  
Cell Dysfunction ◽  
Leading Role ◽  
Excess Production ◽  
Bariatric Patients ◽  
Promising Treatment ◽  
Accelerated Flow

Nowadays obesity is a  major health problem worldwide. Surgery is the most promising treatment for morbid obesity. There are two types of bariatric procedures, one to reduce the food intake volume and the other to limit the absorption of nutrients. Despite the indisputable advantages of bariatric surgery for weight loss, it is necessary to remember the potential risk of severe complications, such as hypoglycemic syndrome at 2 to 3 hours after ingestion of rapidly absorbable carbohydrates manifested by adrenergic and neuroglycopenic symptoms. According to the literature, the prevalence of post-bariatric postprandial hyperinsulinemic hypoglycemia (PHH) varies from 10% to 75%. PHH in post-bariatric patients should be differentiated from the syndrome of non-insulinoma pancreatogenic hypoglycemia and from insulinoma; however, these diseases are described also in patients after bariatric surgery.The mechanisms of PHH as an outcome of shunting bariatric procedures are currently not fully clear. According to the recent studies, incretin hypersecretion in response to the accelerated flow of carbohydrates into the small intestine plays a leading role in the inappropriate excess production of insulin by the pancreas. In addition, there are hypotheses on a slower normalization of insulin production during more rapid bodyweight decrease and regression of insulin resistance, the role of alpha-cell dysfunction, disturbed negative feedback between insulin and ghrelin, compensatory hyperplasia and hypertrophy of the remaining enterocytes (including L-cells), changes in gut microflora, bile acids level and composition. A number of other mechanisms have also been proposed that require further studies.

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