Efficacy of Raw Corn Starch in Insulinoma-Related Hypoglycemia: A Promising Supportive Therapy

Rong-Rong Li; Wei Chen; Xin-Hua Xiao; Miao Yu; Fan Ping; Lian Duan

doi:10.24920/004329

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Efficacy of Raw Corn Starch in Insulinoma-Related Hypoglycemia: A Promising Supportive Therapy

Chinese Medical Sciences Journal Vol. 39, Issue 2, Pages: 102-110(2024)

Research Articles | Updated：2025-03-07

- Efficacy of Raw Corn Starch in Insulinoma-Related Hypoglycemia: A Promising Supportive Therapy
- Affiliations：
  
  1.Department of Clinical Nutrition, Beijing Key Laboratory of the Innovative Development of Functional Staple and the Nutritional Intervention for Chronic Disease, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  2.Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Author bio：
  
  E-mail: txchenwei@sina.com
- Funds：
- DOI：10.24920/004329
  CLC：
- Received：11 December 2023，
  
  Accepted：2024-04-11，
  
  Published Online：17 May 2024，
  
  Published：30 June 2024
- Accepted：
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Li Rong-Rong,Chen Wei,Xiao Xin-Hua,et al.Efficacy of Raw Corn Starch in Insulinoma-Related Hypoglycemia: A Promising Supportive Therapy[J].Chinese Medical Sciences Journal,2024,39(02):102-110.
DOI：

Li Rong-Rong,Chen Wei,Xiao Xin-Hua,et al.Efficacy of Raw Corn Starch in Insulinoma-Related Hypoglycemia: A Promising Supportive Therapy[J].Chinese Medical Sciences Journal,2024,39(02):102-110. DOI： 10.24920/004329.

摘要

Abstract

Objective

To investigate the efficacy of raw corn starch (RCS) in clinical management of insulinoma-induced hypoglycemia.

Methods

We retrospectively collected clinical data of insulinoma patients who received RCS-supplemented diet preoperatively

and analyzed the therapeutic effects of the RCS intervention on blood glucose control

weight change

and its adverse events.

Results

The study population consisted of 24 cases of insulinoma patients

7 males and 17 females

aged 46.08±14.15 years. Before RCS-supplemented diet

all patients had frequent hypoglycemic episodes (2.51±3.88 times/week)

concurrent with neuroglycopenia (in 83.3% of patients) and autonomic manifestations (in 75.0% of patients)

with the median fasting blood glucose (FBG) of 2.70 (interquartile range [IQR

]

: 2.50–2.90) mmol/L. The patients' weight increased by 0.38 (IQR: 0.05–0.65) kg per month

with 8 (33.3%) cases developing overweight and 7 (29.2%) cases developing obesity. All patients maintained the RCS-supplemented diet until they underwent tumor resection (23 cases) and transarterial chemoembolization for liver metastases (1 case). For 19 patients receiving RCS throughout the day

the median FBG within one week of nutritional management was 4.30 (IQR: 3.30–5.70) mmol/L

which was a significant increase compared to pre-nutritional level [2.25 (IQR: 1.60–2.90) mmol/L;

0.001

]

. Of them

10 patients receiving RCS throughout the day for over four weeks had sustained improvement in FBG compared to pre-treatment [3.20 (IQR: 2.60–3.95) mmol/L

. 2.15 (IQR: 1.83–2.33) mmol/L;

0.001). Five patients who received RCS only at night also had a significant increase in FBG within one week of nutritional management [3.50 (IQR: 2.50–3.65) mmol/L

. 2.20 (IQR:1.80–2.60) mmol/L;

0.001

]

but only one patient who continued to receive RCS for over four weeks did not have a significant improvement in FBG. No improvement in weight gain was observed upon RCS supplementation. Mild diarrhea (2 cases) and flatulence (1 case) occurred

and were relieved by reduction of RCS dose.

Conclusion

The RCS-supplemented diet is effective in controlling insulinoma-induced hypoglycemia.

关键词

Keywords

references

Ellison TA , Edil BH . The current management of pancreatic neuroendocrine tumors . Adv Surg 2012 ; 46 : 283 - 96 . doi: 10.1016/j.yasu.2012.04.002 http://dx.doi.org/10.1016/j.yasu.2012.04.002 .

Shao S , Zeng Z , Hu S . An observational analysis of insulinoma from a single institution . QJM 2018 ; 111 ( 4 ): 237 - 41 . doi: 10.1093/qjmed/hcy006 http://dx.doi.org/10.1093/qjmed/hcy006 .

Dardano A , Daniele G , Lupi R , et al . Nesidioblastosis and insulinoma: a rare coexistence and a therapeutic challenge . Front Endocrinol (Lausanne) 2020 ; 11 : 10 . doi: 10.3389/fendo.2020.00010 http://dx.doi.org/10.3389/fendo.2020.00010 .

Bhattacharya K . Dietary dilemmas in the management of glycogen storage disease type I . J Inherit Metab Dis 2011 ; 34 ( 3 ): 621 - 9 . doi: 10.1007/s10545-011-9322-8 http://dx.doi.org/10.1007/s10545-011-9322-8 .

Ross KM , Brown LM , Corrado MM , et al . Safety and efficacy of chronic extended release cornstarch therapy for glycogen storage disease type I . JIMD Rep 2016 ; 26 : 85 - 90 . doi: 10.1007/8904_2015_488 http://dx.doi.org/10.1007/8904_2015_488 .

Axelsen M , Wesslau C , Lonnroth P , et al . Bedtime uncooked cornstarch supplement prevents nocturnal hypoglycaemia in intensively treated type 1 diabetes subjects . J Intern Med 1999 ; 245 ( 3 ): 229 - 36 . doi: 10.1046/j.1365-2796.1999.00432.x http://dx.doi.org/10.1046/j.1365-2796.1999.00432.x .

Axelsen M , Lönnroth P , Lenner RA , et al . Suppression of nocturnal fatty acid concentrations by bedtime carbohydrate supplement in type 2 diabetes: effects on insulin sensitivity, lipids, and glycemic control . Am J Clin Nutr 2000 ; 71 ( 5 ): 1108 - 14 . doi: 10.1093/ajcn/71.5.1108 http://dx.doi.org/10.1093/ajcn/71.5.1108 .

Boneh A , Landau H , Abramovitch N . Raw cornstarch as an additional therapy in nesidioblastosis . Am J Clin Nutr 1988 ; 47 ( 6 ): 1001 - 3 . doi: 10.1093/ajcn/47.6.1001 http://dx.doi.org/10.1093/ajcn/47.6.1001 .

Deguchi A , Okauchi Y , Suehara S , et al . Insulin autoimmune syndrome in a health supplement user: the effectiveness of cornstarch therapy for treating hypoglycemia . Intern Med 2013 ; 52 ( 3 ): 369 - 72 . doi: 10.2169/internalmedicine.52.7844 http://dx.doi.org/10.2169/internalmedicine.52.7844 .

Lechner K , Aulinger B , Brand S , et al . Hydrothermally modified slow release corn starch: a potential new therapeutic option for treating hypoglycemia in autoimmune hypoglycemia (Hirata's disease) . Eur J Clin Nutr 2015 ; 69 ( 12 ): 1369 - 70 . doi: 10.1038/ejcn.2015.151 http://dx.doi.org/10.1038/ejcn.2015.151 .

Lembo E , Lupoli R , Ciciola P , et al . Implementation of low glycemic index diet together with cornstarch in post-gastric bypass hypoglycemia: two case reports . Nutrients 2018 ; 10 ( 6 ): 670 . doi: 10.3390/nu10060670 http://dx.doi.org/10.3390/nu10060670 .

Bell SJ , Forse RA . Nutritional management of hypoglycemia . Diabetes Educ 1999 ; 25 ( 1 ): 41 - 7 . doi: 10.1177/014572179902500106 http://dx.doi.org/10.1177/014572179902500106 .

Kishnani PS , Austin SL , Abdenur JE , et al . Diagnosis and management of glycogen storage disease type I: a practice guideline of the American College of Medical Genetics and Genomics . Genet Med 2014 ; 16 ( 11 ): e1 . doi: 10.1038/gim.2014.128 http://dx.doi.org/10.1038/gim.2014.128 .

Chen YT , Cornblath M , Sidbury JB . Cornstarch therapy in type I glycogen-storage disease . N Engl J Med 1984 ; 310 ( 3 ): 171 - 5 . doi: 10.1056/NEJM198401193100306 http://dx.doi.org/10.1056/NEJM198401193100306 .

Heller S , Worona L , Consuelo A . Nutritional therapy for glycogen storage diseases . J Pediatr Gastroenterol Nutr 2008 ; 47 Suppl 1 : S15 - 21 . doi: 10.1097/MPG.0b013e3181818ea5 http://dx.doi.org/10.1097/MPG.0b013e3181818ea5 .

Smit GP , Berger R , Potasnick R , et al . The dietary treatment of children with type I glycogen storage disease with slow release carbohydrate . Pediatr Res 1984 ; 18 ( 9 ): 879 - 81 . doi: 10.1203/00006450-198409000-00015 http://dx.doi.org/10.1203/00006450-198409000-00015 .

Rokutan M , Yabe D , Komoto I , et al . A case of insulinoma with non-alcoholic fatty liver disease: roles of hyperphagia and hyperinsulinemia in pathogenesis of the disease . Endocr J 2015 ; 62 ( 11 ): 1025 - 30 . doi: 10.1507/endocrj.EJ14-0590 http://dx.doi.org/10.1507/endocrj.EJ14-0590 .

The Helen Diller Comprehensive Cancer Center . Diet tips for insulinoma . 2015 . Available from: https://neuroendocrine.ucsf.edu/sites/g/files/tkssra2606/f/wysiwyg/Insulinoma%20Diet_NET2015.pdf https://neuroendocrine.ucsf.edu/sites/g/files/tkssra2606/f/wysiwyg/Insulinoma%20Diet_NET2015.pdf .

Grant ER BK . Canine insulinoma: diagnosis, treatment, & staging . Today's Veterinary Practice 2016 ; 6 ( 6 ): 60 - 4 .

Goutal CM , Brugmann BL , Ryan KA . Insulinoma in dogs: a review . J Am Anim Hosp Assoc 2012 ; 48 ( 3 ): 151 - 63 . doi: 10.5326/JAAHA-MS-5745 http://dx.doi.org/10.5326/JAAHA-MS-5745 .

Bhattacharya K , Mundy H , Lilburn MF , et al . A pilot longitudinal study of the use of waxy maize heat modified starch in the treatment of adults with glycogen storage disease type I: a randomized double-blind cross-over study . Orphanet J Rare Dis 2015 ; 10 : 18 . doi: 10.1186/s13023-015-0229-6 http://dx.doi.org/10.1186/s13023-015-0229-6 .

Correia CE , Bhattacharya K , Lee PJ , et al . Use of modified cornstarch therapy to extend fasting in glycogen storage disease types Ⅰa and Ⅰb . Am J Clin Nutr 2008 ; 88 ( 5 ): 1272 - 6 . doi: 10.3945/ajcn.2008.26352 http://dx.doi.org/10.3945/ajcn.2008.26352 .

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