True Hyperinsulinism Versus Functional Hypoglycemia

Abstract

In hyperinsulinism, as differentiated from functional or spontaneous hypoglycemia, the patient shows symptoms of receiving too much insulin either by injection or from an insulin-producing tumor.

Criteria for diagnosis of hyperinsulinism are (1) attacks associated with fasting or exercise, or both; (2) blood sugar of less than 50 mg. per 100 cc. during an attack; and (3) prompt relief of attacks with orally administered glucose or intravenously administered dextrose.

When it has been determined that a patient with hyperinsulinism is not receiving insulin surreptitiously and when removal of three-fourths of the pancreas has failed to relieve the hypoglycemia, total pancreatectomy is advised.