Continuous glucose monitoring in an infant with panhypopituitarism having hypoglycemia on growth hormone therapy
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Kaho Kiuchi
,
Satsuki Nakano
Abstract
Objectives
The usefulness of continuous glucose monitoring (CGM) in infants with panhypopituitarism (PH) having hypoglycemia is yet to be explored. The potential adverse effects of growth hormone (GH) replacement therapy, such as hyperglycemia, cannot be comprehensively evaluated using the conventional measurement.
Case presentation
A 2-month-old infant with PH, including severe GH deficiency, had hypoglycemia despite frequent feeding. Glucose levels were monitored using CGM before and after GH replacement therapy. The proportion of time for hypoglycemia decreased from 4.9 to 0% (p<0.017). Hyperglycemia did not increase. The CGM method did not contribute to any adverse events requiring intervention. Our patient only experienced minor bleeding and no episode of cellulitis.
Conclusions
CGM is useful in controlling glucose levels in infants with hypoglycemia and PH.
Funding source: The Foundation for Growth Science
Award Identifier / Grant number: 2021 research grant
Acknowledgments
We thank the family of the patients for providing consent to participate in this study.
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Research funding: This study was partly supported by a 2021 research grant from the Foundation for Growth Science. Neither funding source had any role in the design or conduct of the study.
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Author contributions: Drs. Kiuchi and Sato conceptualized and designed the study, collected data, carried out the analyses, interpreted the data, drafted the initial manuscript, and reviewed and revised the manuscript. Drs. Nakano, Ishii, and Hasegawa conceptualized and designed the study, collected data, carried out the analyses, interpreted the data, drafted the initial manuscript, and critically reviewed the manuscript. All authors approved the final manuscript for submission and agree to be accountable for all aspects of the work.
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Competing interests: Takeshi Sato has indicated a potential conflict of interest to disclose. The other authors have no conflicts of interest to disclose.
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Informed consent: Written consent was obtained from the patient.
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Ethical approval: This study complied with all the relevant national regulations and institutional policies and in accordance with the tenets of the Helsinki Declaration and was approved by the Institutional Review Board at Keio University School of Medicine (Institutional Review Board number 20150104).
References
1. Watanabe, T, Ozawa, A, Ishii, S, Tomaru, T, Shibusawa, N, Saito, T, et al.. Usage of continuous glucose monitoring (CGM) for detecting an unrecognized hypoglycemia and management of glucocorticoid replacement therapy in adult patients with central hypoadrenalism. Endocr J 2018;65:547–56. https://doi.org/10.1507/endocrj.ej16-0387.Search in Google Scholar
2. Christiansen, MP, Garg, SK, Brazg, R, Bode, BW, Bailey, TS, Slover, RH, et al.. Accuracy of a fourth-generation subcutaneous continuous glucose sensor. Diabetes Technol Therapeut 2017;19:446–56. https://doi.org/10.1089/dia.2017.0087.Search in Google Scholar PubMed PubMed Central
3. Shah, R, McKinlay, CJD, Harding, JE. Neonatal hypoglycemia: continuous glucose monitoring. Curr Opin Pediatr 2018;30:204–8. https://doi.org/10.1097/mop.0000000000000592.Search in Google Scholar PubMed PubMed Central
4. Agus, MS, Wypij, D, Hirshberg, EL, Srinivasan, V, Faustino, EV, Luckett, PM, et al.. Tight glycemic control in critically ill children. N Engl J Med 2017;376:729–41. https://doi.org/10.1056/nejmoa1612348.Search in Google Scholar PubMed PubMed Central
5. Hirshberg, EL, Sward, KA, Faustino, EV, Nadkarni, VM, Agus, MS, Morris, AH, et al.. Clinical equipoise regarding glycemic control: a survey of pediatric intensivist perceptions. Pediatr Crit Care Med 2013;14:123–9. https://doi.org/10.1097/pcc.0b013e31826049b3.Search in Google Scholar PubMed
6. Win, M, Beckett, R, Thomson, L, Thankamony, A, Beardsall, K. Continuous glucose monitoring in the management of neonates with persistent hypoglycemia and congenital hyperinsulinism. J Clin Endocrinol Metab 2022;107:e246–53. https://doi.org/10.1210/clinem/dgab601.Search in Google Scholar PubMed PubMed Central
© 2022 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Review Article
- The efficacy and safety of dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 agonists in pediatric patients with type 2 diabetes: a systematic review
- Original Articles
- Triple burden of malnutrition and role of anaemia in the development of complications associated with type 1 diabetes in Indian children and youth
- Effect of obesity and excessive body fat on glycaemic control in paediatric type 1 diabetes
- Role of pan immune inflammatory value in the evaluation of hepatosteatosis in children and adolescents with obesity
- Secular trends of birth weight and its associations with obesity and hypertension among Southern Chinese children and adolescents
- Insights into the implication of obesity in hypogonadism among adolescent boys
- The association between plasma carnitines and duration of diabetic ketoacidosis treatment in children with type 1 diabetes
- Cathelicidin as a marker for subclinical cardiac changes and microvascular complications in children and adolescents with type 1 diabetes
- Developing a risk assessment tool for identifying individuals at high risk for developing insulin resistance in European adolescents: the HELENA-IR score
- Hemoglobin A1C can differentiate subjects with GCK mutations among patients suspected to have MODY
- Perceptions and use of complementary and alternative medicine in patients with precocious puberty
- Case Reports
- Infection with SARS-CoV-2 may alter the half-life of desmopressin (DDAVP) in patients with central diabetes insipidus
- Heterozygous CDC73 mutation causing hyperparathyroidism in children and adolescents: a report of 2 cases
- Wolfram syndrome in a young woman with associated hypergonadotropic hypogonadism – A case report
- Continuous glucose monitoring in an infant with panhypopituitarism having hypoglycemia on growth hormone therapy
- Severe consumptive hypothyroidism in hepatic hemangioendothelioma
- Efficacy of aromatase inhibitor therapy in a case with large cell calcifying Sertoli cell tumour-associated prepubertal gynaecomastia
