Transient neonatal hyperinsulinism: early predictors of duration

Shai Fuchs; Ravit Regev; Jennifer Harrington

doi:10.1515/jpem-2020-0594

Article

Transient neonatal hyperinsulinism: early predictors of duration

Shai Fuchs , Ravit Regev and Jennifer Harrington

Published/Copyright: April 16, 2021

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 34 Issue 8

Abstract

Objectives

Hyperinsulinism is the most common cause of recurrent hypoglycemia in infants, with transient and permanent forms. Currently, there are no effective tools to predict severity and time to resolution in infants with transient hyperinsulinism (tHI). Therefore, our objective was to assess whether early glucose trends predict disease duration in tHI.

Methods

A retrospective, pilot cohort of infants admitted with tHI was phenotyped for clinical and laboratory parameters. Blood glucose (BG) values were collected from the first documented hypoglycemia for 120 h (five days).

Results

In 27 neonates with tHI, the presence of fetal distress (p=0.001) and higher mean daily BG (p=0.035) were associated with shorter time to resolution of hypoglycemia. In a further sensitivity analysis that grouped the cohort by the presence or absence of fetal distress, we found that in neonates without fetal distress, lower mean daily glucose was associated with longer disease duration (R²=0.53, p=0.01).

Conclusions

Our pilot data suggests that predictors for disease duration of tHI may be elicited in the first week of life, and that tHI associated with fetal distress may represent a distinct clinical entity with a shorter time course.

Keywords: disease duration; fetal distress; hyperinsulinism; neonates

Corresponding author: Jennifer Harrington, MBBS, PhD, Division of Endocrinology, Department of Pediatrics, The Hospital for Sick Children, 555 University Avenue, Toronto, ONM5G 1X8, Canada, Phone: +1 416 813 7500, Fax: +1 416 813 6304, E-mail: jennifer.harrington@sickkids.ca

Dr. Shai Fuchs and Dr. Ravit Regev served as co-first authors, each with equal contribution to the manuscript.

Acknowledgments

We thank Nicole Falzone for her work in originally collecting some of the initial data. We thank Uri Alon and Yael Korem from the Weizmann Institute of Science for fruitful discussions at the conception of the underlying hypothesis.

Research funding: No funding was secured for this study.
Competing interest: The authors have no conflicts of interest to disclose.
Ethical approval: This study was approved by the Research and Ethics Board at the Hospital for Sick Children, Toronto ON (REB#1000053997).

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2020-0594).

Received: 2020-10-13

Accepted: 2021-02-22

Published Online: 2021-04-16

Published in Print: 2021-08-26

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Supplementary Material

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https://doi.org/10.1515/jpem-2020-0594

Keywords for this article

disease duration; fetal distress; hyperinsulinism; neonates