Which medications in the drug class Insulin secretion inhibiting agents are used in the treatment of Pediatric Hypoglycemia?

Updated: Feb 19, 2018
  • Author: Robert P Hoffman, MD; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

Insulin secretion inhibiting agents

Various mechanisms may alter insulin secretion. Diazoxide inhibits pancreatic secretion of insulin, stimulates glucose release from the liver, and stimulates catecholamine release, which elevates blood glucose levels. Octreotide is a peptide with pharmacologic action similar to that of somatostatin, which inhibits insulin secretion.

ATP-sensitive potassium channels (composed of the sulfonylurea receptor [SUR] and the potassium channel pore protein [Kir6.2]) function abnormally in persistent hyperinsulinemic hypoglycemia of infancy. These channels initiate depolarization of the beta-cell membrane and opening of calcium channels. The resultant increase in intracellular calcium triggers insulin secretion. Calcium channel blockers block the action of these calcium channels, decreasing insulin secretion. Nifedipine is the only calcium channel blocker for which data have been reported in clinical trials in humans.

Diazoxide (Proglycem)

Diazoxide is a first-line medical treatment for hyperinsulinism. This agent inhibits insulin release from the pancreas.

Octreotide (Sandostatin)

Octreotide, a synthetic polypeptide, is usually the second-line therapy for hyperinsulinism. It inhibits the release of many biologically active substances, including insulin.

Nifedipine (Adalat, Procardia, Afeditab)

Nifedipine acts to block calcium influx, which stimulates insulin secretion.


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