CLINICAL ASPECTS OF HYPERINSULINISM

Abstract

• Hyperinsulinism in forms satisfying rigid diagnostic criteria was found in 91 cases. The attacks must be associated with exercise or fasting, the blood sugar level during an attack must be less than 50 mg. per 100 cc., and the attack must be relieved by the administration of sugar. Electroencephalograms do not help in the differential diagnosis. Fasting up to 72 hours is a valuable diagnostic test and has replaced the glucose tolerance test. Although hyperinsulinism is rare, it was found in all age groups from 9 to 72 years. A study of family histories indicated a positive relation to diabetes. The treatment is laparotomy and pancreatic exploration. In 76 of the 91 cases an actual tumor of the islet cells of the pancreas was found.