Hyperinsulism or hyperinsulinemia is a condition in which the body's cells do not respond properly to insulin, the hormone that functions to control blood sugar levels. Insulin transports nutrients (mainly glucose) across cell membranes.
With insulin resistance, less glucose is absorbed from the blood, resulting in higher insulin secretion.
Hypoglycemia due to hyperinsulinism can be a feature of insulinoma, a (usually benign) tumor that secretes insulin.
Hyperinsulinism causes a particularly damaging form of hypoglycaemia because it denies the brain of all the fuels on which it is critically dependent.
The diagnosis of hyperinsulinism may be quite difficult if one relies on demonstrating an elevated blood insulin concentration at the time of hypoglycaemia because insulin levels fluctuate widely over time in patients with hyperinsulinism.
The identification of genetic defects responsible for hyperinsulinism and the improved understanding of the mechanism of abnormal insulin secretion have permitted the development of insulin secretion studies aimed at identifying the specific type of hyperinsulinism a child may have.
Hyperinsulinism can be associated with several types of medical problems, which can be roughtly divided into two broad categories: those tending toward high blood glucose levels (hyperglycemia) and those tending toward low glucose levels (hypoglycemia).
The principal treatments of hyperinsulinism due to insulin resistance are measures that improve insulin sensitivity, such as weight loss, physical exercise, and drugs such as thiazolidinediones or metformin.
The treatment of this form of hyperinsulinism depends on the cause and the severity of the hyperinsulinism, and may include surgical removal of the source of insulin, or a drug such as diazoxide or octreotide that reduces insulin secretion.
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