Hiperinsulinismo endógeno: revisão e seguimento de 24 casos Endogenous hyperinsulinism: review and follow-up of 24 cases

SUMMARY Hypoglycemia due to endogenous hyperinsulinism (EH) is diagnosed in a symptomatic patient with low levels of plasma glucose concomitant with elevated plasma insulin and C-peptide. Cau- ses of EH are pancreatic islet-cells disease, use of insulin secretagogues, and autoimmune hypo- glycemia. In this review, the authors studied 24 patients with hypoglycemia due to endogenous hyperinsulinism in order to describe aspects of diagnosis and treatment. Our study demonstra- ted that after 12 hours of fasting (mini-fasting test; at least three samples), all patients presen- ted the diagnostic criteria for EH. Additionally, we found that 11 of 12 patients (91.7%) who un- derwent glucagon test achieved glucose levels less than 50 mg/dL and below baseline after 120 minutes. Mini-fasting (3 samples) and glucagon test may be useful to prevent prolonged fasting test to clarify the diagnosis of endogenous hyperinsulinism. Arq Bras Endocrinol Metab. 2012;56(2):83-95