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Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts

Contributors

van Albada, Mirjam E; Shah, Pratik; Derks, Terry G J; Fuchs, Sabine; Jans, Judith J M; Mclin, Valérie Anne; van der Doef, Hubert P J

Published in

Frontiers in endocrinology, vol. 14, 1190473

Publication date

2023

First online date

2023-08-18

Abstract

In physiological glucose homeostasis, the liver plays a crucial role in the extraction of glucose from the portal circulation and storage as glycogen to enable release through glycogenolysis upon fasting. In addition, insulin secreted by the pancreas is partly eliminated from the systemic circulation by hepatic first-pass. Therefore, patients with a congenital porto-systemic shunt present a unique combination of (a) postabsorptive hyperinsulinemic hypoglycaemia (HH) because of decreased insulin elimination and (b) fasting (ketotic) hypoglycaemia because of decreased glycogenolysis. Patients with porto-systemic shunts therefore provide important insight into the role of the portal circulation and hepatic function in different phases of glucose homeostasis.

Keywords

  • Congenital hyperinsulinism
  • Congenital porto-systemic shunt
  • Glucose metabolism
  • Hyperinsulinism
  • Hypoglycaemia
  • Insulin
  • Portal circulation
  • Humans
  • Fasting
  • Glucose
  • Homeostasis
  • Hypoglycemia

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

VAN ALBADA, Mirjam E et al. Abnormal glucose homeostasis and fasting intolerance in patients with congenital porto-systemic shunts. In: Frontiers in endocrinology, 2023, vol. 14, p. 1190473. doi: 10.3389/fendo.2023.1190473

Main files (1)

Article (Published version)
CC BY-4.0

Identifiers

Additional URL for this publication

https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1190473/full

Journal ISSN

1664-2392
127views
265downloads

Technical informations

Creation

23/10/2024 05:55:23

First validation

26/11/2024 13:31:58

Update

19/09/2025 10:07:11

Status update

19/09/2025 10:07:11

Last indexation

19/09/2025 10:10:26
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