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Arch Dis Child 2001;84:254-257 ( March )

Article

Exercise induced hypoglycaemic hyperinsulinism T Meissnera, T Otonkoskic, R Fenebergb, B Beinbrecha, S Apostolidoua, I Sipiläc, F Schaeferb, E Mayatepeka

a Division of Metabolic and Endocrine Diseases, University Children's Hospital, Im Neuenheimer Feld 150, D-69120 Heidelberg, Germany, b Division of Pediatric Nephrology, Department of General Pediatrics, University Children's Hospital, c Hospital for Children and Adolescents, Haartman Institute, University of Helsinki, Finland

Correspondence to: Dr Mayatepek ertan_mayatepek{at}med.uni-heidelberg.de

Accepted 20 September 2000

BACKGROUND---Hyperinsulinism in childhood is often caused by genetic defects involving the regulation of insulin secretion leading to recurrent episodes of hypoglycaemia. We report two patients with exercise induced hypoglycaemia.
METHODS---Standardised short exercise tests with frequent blood glucose and plasma insulin measurements were performed in the patients and young healthy controls.
RESULTS---Short term exercise resulted in insulin induced hypoglycaemia 15 to 50 minutes after the end of exercise. A massive burst of insulin secretion was observed within a few minutes of the start of exercise in both patients. By contrast glucose and insulin concentrations remained unchanged in healthy controls.
CONCLUSIONS---Hyperinsulinaemic hypoglycaemia after moderate physical exercise represents a rarely described phenotype of hyperinsulinism with an as yet unknown defect in the regulation of insulin secretion. It should be suspected in individuals with recurrent exercise related syncope or disturbance of consciousness.


Keywords: exercise; hypoglycaemia; hyperinsulinism; congenital hyperinsulinism

© 2001 by Archives of Disease in Childhood


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