Question

Congenital hyperinsulinism is a rare condition in which infants experience frequent episodes of hypoglycemia. Based on the functions of the two main hormones that control blood sugar homeostasis, hypothesize how medications might be used to counteract the effects of congenital hyperinsulinism.

Answer 1

Congenital hyperinsulinism is a congenital disorder in which hypoglycemia is caused by excessive insulin secretion. These conditions are present at birth but may give its full effects in early infancy. Mild cases can be treated by frequent feedings, but more severe conditions requires medication that reduce insulin secretion or its effects. Medications are given for maintaining the required glucose level. Some of the medicines are:

1. Diazoxide: It is still the first choice of drug in use. This drug works by preventing insulin release from the pancreas, helping to return the blood sugar to normal levels.

2. Chlorothiazide: It is generally given along diazoxide as the side effect of diazoxide is fluid retention. It works by causing the kidney to get rid of unwanted water and salts from the body into the urine.

3. Octreotide: It is generally given as a second line of treatment to patients who have become unresponsive to diazoxide. It has insulin inhibitory effects which reduces the secretion of insulin from pancreas.

4. Pancreatectomy: Removal of a portion, or all of pancreas is usually the treatment of last choice when the other treatments have failed.