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Congenital hyperinsulinism: Global and J apanese perspectives
Author(s) -
Yorifuji Tohru,
Masue Michiya,
Nishibori Hironori
Publication year - 2014
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12390
Subject(s) - medicine , diazoxide , congenital hyperinsulinism , hyperinsulinism , ethnic group , modalities , pancreatectomy , intensive care medicine , treatment modality , pediatrics , insulin , surgery , pancreas , insulin resistance , social science , sociology , anthropology
Over the past 20 years, there has been remarkable progress in the diagnosis and treatment of congenital hyperinsulinism ( CHI ). These advances have been supported by the understanding of the molecular mechanism and the development of diagnostic modalities to identify the focal form of ATP‐sensitive potassium channel CHI . Many patients with diazoxide‐unresponsive focal CHI have been cured by partial pancreatectomy without developing postsurgical diabetes mellitus. Important novel findings on the genetic basis of the other forms of CHI have also been obtained, and several novel medical treatments have been explored. However, the management of patients with CHI is still far from ideal. First, state‐of‐the‐art treatment is not widely available worldwide. Second, it appears that the management strategy needs to be adjusted according to the patient's ethnic group. Third, optimal management of patients with the diazoxide‐unresponsive, diffuse form of CHI is still insufficient and requires further improvement. In this review, we describe the current landscape of this disorder, discuss the racial disparity of CHI using J apanese patients as an example, and briefly note unanswered questions and unmet needs that should be addressed in the near future.