The immediate priority of management of hypoglycaemia (low sugars) in the context of Congenital Hyperinsulinism (CHI), is to stabilise the sugar levels. Ideally, all sugars should be more than 3.5 mmol/l. To achieve this, your doctors may wish to put in a 'central line', which is a tube that goes into a big vein. Using a central line, strong solutions of sugar can be given safely.
There are various other ways to stabilise hypoglycaemia in the initial phases. One type of medication, called glucagon, can be put in a drip and given into a vein. In children who are relatively stable, regular oral feeding, sometimes with a sugar supplement may be all that is necessary.
Once CHI is confirmed, your doctors may want to start a medication called Diazoxide, given my mouth. This medication works on the “potassium channel” in the pancreatic cell. In the CHI cell, the potassium channel is closed for a lot of the time, causing too much insulin production. Diazoxide tries to open this channel and therefore quieten insulin production. Another medicine, called Octreotide can be given either under the skin or into a vein. Octreotide also calms the pancreatic cell and slows down the production of insulin.
Diazoxide is the first line of treatment for CHI. If this fails, Octreotide is used. If no response is achieved with Octreotide, surgery to the pancreas may have to be undertaken.