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Table 1 Criteria for diagnosing hyperinsulinism

From: Monogenic hyperinsulinemic hypoglycemia: current insights into the pathogenesis and management

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

  1. * Glucagon stimulation test: When glucose < 50 mg/dL,administer 1 mg glucagon IV/IM and monitor glucose every10 min for 40 min. If there is no increase in bloodglucose by 20 min, terminate test and rescue with IV dextrose.GIR = glucose infusion rate.
  2. # Please note that in some cases the GIR may be lower.