Endocrinology clinical outcomes

Clinical outcomes are broadly agreed, measurable changes in health or quality of life that result from our care. Constant review of our clinical outcomes establishes standards against which to continuously improve all aspects of our practice.

About the Endocrinology Service

The Department of Endocrinology and Diabetes at Great Ormond Street Hospital (GOSH), in partnership with adolescent and adult services at University College London Hospitals (UCLH), form the London Centre for Paediatric Endocrinology and Diabetes.

Congenital hyperinsulinism

Introduction

Congenital hyperinsulinism (CHI) is a very complex medical condition that presents with severe hypoglycaemia (low blood glucose) in the neonatal, infancy and childhood period. With congenital hyperinsulinism, the pancreas produces too much insulin, which is the main hormone that has an important role in controlling blood glucose levels. The raised levels of insulin are inappropriate for the levels of glucose in the blood, and as a result the blood glucose levels can become dangerously low.

The Congenital Hyperinsulinism Centre at Great Ormond Street Hospital has over 650 patients on our database, making it one of the largest national and international referral centres for the condition. 

There are two types of CHI, known as diffuse and focal. Diffuse hyperinsulinism affects the entire pancreas, whereas focal hyperinsulinism affects a specific area of the pancreas. These two forms of CHI require different treatment approaches, ranging from medical therapy to surgical treatment. The data below shows our treatment outcome for focal CHI.

Focal congenital hyperinsulinism clinical outcome

From 2010-2013, the Congenital Hyperinsulinism Centre at GOSH treated 10 patients diagnosed with focal hyperinsulinism. 100% of these patients have been cured after laparoscopic (keyhole surgery) removal of the focal lesion. This means they are now cured of CHI and are able to maintain normal blood glucose levels without further medical intervention. This outcome demonstrates highly effective surgical and medical management of the condition.

Graph showing 100% cure rate of patients with Focal Congenital Hyperinsulinism 2010-2012

These results will be updated in February 2016.