Reactive hypoglycaemia in association with disordered islet function and abnormal hepatic glucose-6-phosphatase activity: response to diazoxide
Pears, J.; Jung, R.T.; Browning, M.C.; Taylor, R.; Burchell, A.
Diabetic medicine a journal of the British Diabetic Association 8(3): 268-271
1991
ISSN/ISBN: 0742-3071 PMID: 1646698 Document Number: 383091
Severe reactive hypoglycaemia was confirmed in a non-diabetic male patient by a counter-regulatory hormone (GH, cortisol and catecholamine) response to profound hypoglycaemia induced by an intravenous glucose load. There was also evidence of disordered pancreatic islet cell paracrine regulation with hyperinsulinaemia and absent glucagon response to hypoglycaemia. A defect in the patient's hepatic glucose-6-phosphatase enzyme system was documented. Because of severe symptoms, dietary control was insufficient, but the patient responded clinically and biochemically to 18 months of oral diazoxide therapy. He also showed good biochemical response to a single dose (100 micrograms IM) of the somatostatin analogue octreotide.