Hyperinsulinemic hypoglycemia in growth restricted convalescent preterm neonates: clinical characteristics and impediments to early diagnosis.

Document Type

Article

Publication Date

3-28-2022

Identifier

DOI: 10.1515/jpem-2021-0515

Abstract

OBJECTIVES: Describe clinical characteristics, course, and risk factors for hyper-insulinemic hypoglycemia (HIH) in preterm infants and identify impediments to early diagnosis.

METHODS: Electronic records of infant-mother dyads were used to describe clinical characteristics, lab parameters, and course of HIH.

RESULTS: All eight patients (gestational ages 26w0d-29w3d) had intrauterine growth restriction (IUGR) due to placental insufficiency, (4/8) were small for gestational age. All maintained normal glucose levels with glucose infusion during the first 48 h six of eight patients had cholestasis despite being on parenteral nutrition for short time (average 17 days). Four of eight patients were treated with diazoxide (average 22 days). Four of eight patients who recovered spontaneously (average 49 days after diagnosis) responded to continuous feeds and hydrocortisone for other clinical indications.

CONCLUSIONS: In IUGR preterms, HIH is asymptomatic, may be prolonged, requiring diazoxide treatment. Transient cholestasis is seen in majority of patients. Euglycemia should be demonstrated on bolus gavage feeds, off glucocorticoids before discontinuing blood glucose monitoring.

Journal Title

Journal of pediatric endocrinology & metabolism : JPEM

Volume

35

Issue

3

First Page

319

Last Page

323

Keywords

cholestasis; hyper-insulinemic hypoglycemia; intrauterine growth retardation; premature infants

Link to Full Text
Library Record

Share

COinS