title: Hydrothermally modified slow release corn starch: a potential new therapeutic option for treating hypoglycemia in autoimmune hypoglycemia (Hirata's disease).
abstract: We report the successful treatment of autoimmune hypoglycemia in an 82-year-old non-diabetic Caucasian male with hydrothermally modified slow release corn starch, a product which is used in other conditions associated with hypoglycemia, most typically glycogen storage disease type I. An 82-year-old-Caucasian male presented with recurrent spontaneous hypoglycemia as low as 30 mg/dl following in-patient treatment for community acquired pneumonia. During a fasting-test, symptomatic hypoglycemia occurred. Plasma concentrations of c-peptide and insulin were considerably elevated. Autoimmune hypoglycemia was confirmed by the presence of insulin autoantibodies. While dietary restriction alone did not result in sufficient glucose control in this patient with autoimmune hypoglycemia, treatment with hydrothermally modified slow release corn starch led to stable euglycemia. This easy, well tolerated and non-invasive treatment may constitute a new therapeutic option for hypoglycemia in patients with autoimmune hypoglycemia who do not achieve sufficient control of hypoglycemia by dietary restriction alone.
authors.affiliation: Department of Medicine II, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Lechner
authors.affiliation: Department of Medicine II, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Aulinger
authors.affiliation: Department of Medicine II, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Brand
authors.affiliation: Department of Medicine II, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Waldmann
authors.affiliation: Department of Medicine II, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: K G
authors.initials: KG
authors.lastname: Parhofer
mesh_terms: D000369:Aged, 80 and over; D002096:C-Peptide / Q000097:blood; D003692:Delayed-Action Preparations / Q000737:chemistry / Q000627:therapeutic use*; D005953:Glycogen Storage Disease Type I / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy*; D007328:Insulin / Q000097:blood; D007330:Insulin Antibodies / Q000097:blood; D008297:Male; D013213:Starch / Q000737:chemistry / Q000627:therapeutic use*; D003313:Zea mays / Q000737:chemistry*
chemical_list: D002096:C-Peptide; D003692:Delayed-Action Preparations; D007328:Insulin; D007330:Insulin Antibodies; D013213:Starch