Beckwith-Wiedemann Syndrome Medication

Updated: Dec 05, 2016
  • Author: Sunil Kumar Sinha, MD; Chief Editor: Robert P Hoffman, MD  more...
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Medication

Medication Summary

The first line of treatment for hypoglycemia remains infusion of dextrose. If the patient cannot be weaned from the dextrose infusion within a week of the Beckwith-Wiedemann syndrome (BWS) diagnosis, one should consider diazoxide.

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Insulin secretion inhibiting agents

Class Summary

Insulin secretion may be altered by various mechanisms. 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 somatostatin, which inhibits insulin secretion. ATP-sensitive potassium channels (composed of the sulfonylurea receptor [SUR] and the potassium channel pore protein [Kir6.2]) are believed to function abnormally in nesidioblastosis. 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 that has been reported in clinical trials in humans.

Diazoxide (Proglycem)

Acts by binding the sulfonylurea receptor (SUR1) of the pancreatic beta cell, thereby inhibiting insulin secretion. Oral diazoxide (Proglycem) opens KATP channels and inhibits insulin secretion. Intravenous diazoxide (Hyperstat) is primarily used as an antihypertensive agent. This preparation is not used in hyperinsulinism.

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