Successful Treatment of Persistent Hyperinsulinemic Hypoglycemia with Nifedipine in an Adult Patient
Open accessAbstract
Objective To describe the successful treatment of severe noninsulinoma hyperinsulinemic hypoglycemia with use of a calcium channel blocking agent in an adult patient who had previously undergone a gastric bypass surgical procedure. Methods A 65-year-old woman who had undergone a gastric bypass surgical procedure 26 years earlier was hospitalized because of severe postprandial hypoglycemia. During and after hospitalization, the patient underwent assessment with conventional measurements of glucose, insulin, proinsulin, and C-peptide; toxicologic studies; magnetic resonance imaging studies of the pancreas; and determination of hepatic vein insulin concentrations after selective splanchnic artery calcium infusion. Results Metabolic variables were consistent with the diagnosis of hyperinsulinemic hypoglycemia. Magnetic resonance imaging revealed the presence of a side branch intraductal papillary mucinous tumor that had been stable for more than 1 year. The results of the calcium-stimulated insulin release study were consistent with nonlocalized hypersecretion of insulin. A trial of frequent small feedings failed to prevent hypoglycemia. On the basis of reports of successful treatment of childhood nesidioblastosis, the patient was then prescribed nifedipine, 30 mg daily. She has subsequently remained free of symptomatic hypoglycemia for 20 months. Conclusion A calcium channel blocking agent may be efficacious and a potential alternative to partial pancreatectomy in cases of noninsulinoma hyperinsulinemic hypoglycemia in adults.
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Nifedipine successfully controlled persistent hyperinsulinemic hypoglycemia in a case report of an adult patient with dumping syndrome that occurred after gastric bypass surgery.
“Nifedipine, a calcium channel blocking agent, successfully controlled persistent hyperinsulinemic hypoglycemia in a case report of an adult patient with dumping syndrome that occurred after gastric bypass surgery (104).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [104]
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- Authors
- Guseva, N., Phillips, D., & Mordes, J. P.
- Affiliations
- University of Massachusetts Chan Medical School (US)
- Pediatrics and Genetics (US)
- Corresponding author
- Mordes, John P.
- Venue
- Endocrine Practice
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 16
- Issue
- 1
- Pages
- 107-111
- ISSN
- 1530-891X (ISSN-L)
- PMC
- PMC3979460
- OpenAlex
- W2012289105
- Cited by
- 35
- References
- 23
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 1 · 2016: 7 · 2015: 2 · 2014: 2 · 2013: 3
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Endocrine Practice (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007302, P30DK032520)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- nifedipine, calcium channel blockers, gastric bypass, intraductal papillary mucinous neoplasm, insulin hypersecretion, postprandial hypoglycemia
- MeSH terms
- Aged, Female, Humans, Hyperinsulinism, Hypoglycemia, Nifedipine
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