Table 1

Criteria for diagnosing hyperinsulinism
Clinical Clues Large for gestational age
GIR > 10 mg/kg/min#
Lab findings with glucose < 50 mg/dL ↓ Beta-hydroxybutyrate (< 0.6 mM)
↓ Free fatty acids (< 0.5 mM)
+/− ↑ Insulin
Glycemic Response to Glucagon* ↑ Glucose > 30 mg/dL

* Glucagon stimulation test: When glucose < 50 mg/dL, administer 1 mg glucagon IV/IM and monitor glucose every 10 min for 40 min. If there is no increase in blood glucose by 20 min, terminate test and rescue with IV dextrose. GIR = glucose infusion rate.

# Please note that in some cases the GIR may be lower.

Lord and De León

Lord and De León International Journal of Pediatric Endocrinology 2013 2013:3   doi:10.1186/1687-9856-2013-3

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