{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T20:03:23Z","timestamp":1781381003727,"version":"3.54.1"},"reference-count":68,"publisher":"Walter de Gruyter GmbH","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"j_jpem-2018-0086_s_999\"><jats:title id=\"d3868931e526\">Background<\/jats:title><jats:p>Congenital central hypoventilation syndrome (CCHS) is a rare disorder of autonomic control. A hypoglycaemic seizure in a 4-year-old girl with CCHS led to a more detailed examination of glycaemic control in a cohort of children with CCHS.<\/jats:p><\/jats:sec><jats:sec id=\"j_jpem-2018-0086_s_998\"><jats:title id=\"d3868931e534\">Methods<\/jats:title><jats:p>We conducted an observational cohort study of glucose homeostasis in seven children (3 months to 12 years) with genetically confirmed CCHS using a combination of continuous glucose monitoring (CGM), fasting studies and oral glucose tolerance test (OGTT). CGM was used to compare the effect of diazoxide and dietary intervention in the index patient.<\/jats:p><\/jats:sec><jats:sec id=\"j_jpem-2018-0086_s_997\"><jats:title id=\"d3868931e542\">Results<\/jats:title><jats:p>Hypoglycaemia was not elicited by fasting in any of the patients. Increased postprandial glycaemic variability was evident in all patients using CGM, with seven of seven patients demonstrating initial postprandial hyperglycaemia (plasma-glucose concentration &gt;7.8 mmol\/L), followed by asymptomatic hypoglycaemia (plasma-glucose concentration \u22642.8 mmol\/L) in two of seven patients that was also demonstrated on OGTT. Both diazoxide and low Glycaemic Index (GI) dietary intervention reduced the proportion of CGM readings &lt;4 mmol\/L; however, diazoxide also increased the proportion of readings in the hyperglycaemic range.<\/jats:p><\/jats:sec><jats:sec id=\"j_jpem-2018-0086_s_996\"><jats:title id=\"d3868931e550\">Conclusions<\/jats:title><jats:p>Glucose variability associated with autonomic dysfunction may be unrecognised in CCHS, particularly in children with more severe phenotypes. This report highlights the occurrence of hyperglycaemia as well as hypoglycaemia in CCHS. Given the challenges of recognising hypoglycaemia based on clinical symptomatology, the use of CGM may facilitate its identification allowing appropriate management. The observed normoglycaemia during fasting combined with increased postprandial plasma blood glucose level (BGL) variability is more consistent with dumping syndrome than persistent hyperinsulinism. Dietary modifications therefore may be more effective than diazoxide in managing hypoglycaemia.<\/jats:p><\/jats:sec>","DOI":"10.1515\/jpem-2018-0086","type":"journal-article","created":{"date-parts":[[2018,11,17]],"date-time":"2018-11-17T11:42:56Z","timestamp":1542454976000},"page":"1325-1333","source":"Crossref","is-referenced-by-count":8,"title":["Dysregulated glucose homeostasis in congenital central hypoventilation syndrome"],"prefix":"10.1515","volume":"31","author":[{"given":"Yassmin Mansela","family":"Musthaffa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas","family":"Goyal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret-Anne","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Kapur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Leger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","reference":[{"key":"ref211","first-page":"791","article-title":"Postprandial hyperinsulinemic hypoglycemia in a child as a late complication of esophageal reconstruction","volume":"30","year":"2017","journal-title":"J 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Paediatr"},{"key":"ref371","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1164\/rccm.200402-245PP","article-title":"Genetics of congenital central hypoventilation syndrome: lessons from a seemingly orphan disease","volume":"170","year":"2004","journal-title":"Am J Respir Crit Care Med"},{"key":"ref461","doi-asserted-by":"crossref","first-page":"P122","DOI":"10.1186\/1687-9856-2015-S1-P122","article-title":"Congenital central hypoventilation syndrome with hyperinsulinemia in an infant.","volume":"2015","year":"2015","journal-title":"Int J Pediatr Endocrinol"},{"key":"ref531","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1089\/dia.2007.0293","article-title":"Characterizing glucose exposure for individuals with normal glucose tolerance using continuous glucose monitoring and ambulatory glucose profile analysis","volume":"10","year":"2008","journal-title":"Diabetes Technol 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