Hyperinsulinemic hypoglycemia evolving to gestational diabetes and diabetes mellitus in a family carrying the inactivating ABCC8 E1506K mutation
| Autor: | Carla Sanchez Bergamin, Teresa C. Vieira, Lucimary C. Gurgel, Regina S. Moisés |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Endocrinology Diabetes and Metabolism Receptors Drug Type 2 diabetes Hypoglycemia medicine.disease_cause Octreotide Sulfonylurea Receptors Diabetes mellitus genetics Germline mutation Pregnancy Internal medicine Diabetes mellitus Internal Medicine medicine Diabetes Mellitus Humans Potassium Channels Inwardly Rectifying Hyperinsulinemic hypoglycemia Child business.industry Diazoxide Infant Newborn medicine.disease Gestational diabetes Diabetes Gestational Endocrinology Pediatrics Perinatology and Child Health Congenital hyperinsulinism ATP-Binding Cassette Transporters Congenital Hyperinsulinism Female Epilepsy Tonic-Clonic business |
| Zdroj: | Pediatric diabetes. 11(7) |
| ISSN: | 1399-5448 |
| Popis: | Congenital hyperinsulinism of infancy (CHI) is the most common cause of hypoglycemia in newborns and infants. Several molecular mechanisms are involved in the development of CHI, but the most common genetic defects are inactivating mutations of the ABCC8 or KCNJ11 genes. The classical treatment for CHI has been pancreatectomy that eventually leads to diabetes. More recently, conservative treatment has been attempted in some cases, with encouraging results. Whether or not the patients with heterozygous ABCC8 mutations submitted to conservative treatment may spontaneously develop type 2 diabetes in the long run, is a controversial issue. Here, we report a family carrying the dominant heterozygous germ line E1506K mutation in ABCC8 associated with persistent hypoglycemia in the newborn period and diabetes in adulthood. The mutation occurred as a de novo germ line mutation in the mother of the index patient. Her hypoglycemic symptoms as a child occurred after the fourth year of life and were very mild, but she developed glucose metabolism impairment in adulthood. On the other hand, in her daughter, the clinical manifestations of the disease occurred in the neonatal period and were more severe, leading to episodes of tonic-clonic seizures that were well controlled with octreotide or diazoxide. Our data corroborate the hypothesis that the dominant E1506K ABCC8 mutation, responsible for CHI, predisposes to the development of glucose intolerance and diabetes later in life. |
| Databáze: | OpenAIRE |
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