Factors associated with neonatal hyperinsulinemic hypoglycemia, a case-control study

Thanaporn Rattanasakol; Ratchada Kitsommart

doi:10.1515/jpem-2023-0526

Artikel

Factors associated with neonatal hyperinsulinemic hypoglycemia, a case-control study

Thanaporn Rattanasakol und Ratchada Kitsommart

Veröffentlicht/Copyright: 19. Januar 2024

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Aus der Zeitschrift Journal of Pediatric Endocrinology and Metabolism Band 37 Heft 3

Abstract

Objectives

We aimed to identify perinatal risk factors associated with hyperinsulinemic hypoglycemia in neonates. Secondary objectives included an examination of clinical and biochemical characteristics at the time of diagnosis and an exploration of the duration of diazoxide therapy.

Methods

A case-control study was conducted, involving individual chart reviews of inborn infants diagnosed with hyperinsulinemic hypoglycemia (the HH group) between 2014 and 2021. These cases were paired with controls (the non-HH group) belonging to the same gestational age (GA) strata who did not exhibit HH or only had transient postnatal hypoglycemia.

Results

A total of 52 infants with HH were matched with corresponding controls. The mean GA in the HH group was 34.4 ± 3.1 weeks. Notably, the HH group exhibited lower mean minimum plasma glucose (PG) levels and required higher glucose infusion rates in comparison to the non-HH group (26.5 ± 15.6 vs. 49.1 ± 37.7 mg/dL and 12.9 ± 3.8 vs. 5.7 ± 2.1 mg/kg/min, respectively; p<0.001 for both). After adjusting for potential confounding factors, only two variables, fetal growth restriction (FGR) and neonatal sepsis, demonstrated significant associations with HH (adjusted odds ratio [95 % confidence interval]: 8.1 [2.1–31.0], p=0.002 and 6.3 [1.9–21.4], p=0.003, respectively). The median duration of diazoxide therapy for the HH group was 4 months.

Conclusions

FGR and neonatal sepsis emerged as notable risk factors for HH. These infants exhibited lower PG levels and necessitated higher glucose infusion rates compared to their non-HH counterparts. Importantly, a substantial proportion of the HH group received diazoxide therapy, with a median treatment duration of 4 months.

Keywords: diazoxide; hyperinsulinism; neonatal hypoglycemia; postnatal; risk factors

Corresponding author: Ratchada Kitsommart, MD, Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700, Thailand, Phone: +662 419 7000, ext. 95713, Fax: +662 411 3010, E-mail: rkitsommart@hotmail.com

Research ethics: This study was conducted in accordance with the Declaration of Helsinki (as revised in 2013) and the study protocol was approved by the Siriraj Institutional Review Board.
Informed consent: Not applicable.
Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission. TR conceptualized the study, performed data collection, and data analysis. R.K. conceptualized, designed the study, and drafted the initial manuscript. Both approved the final manuscript as submitted.
Competing interests: The authors state no conflict of interest.
Research funding: None declared.
Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2023-11-27

Accepted: 2024-01-04

Published Online: 2024-01-19

Published in Print: 2024-03-25

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Artikel in diesem Heft

https://doi.org/10.1515/jpem-2023-0526

Schlagwörter für diesen Artikel

diazoxide; hyperinsulinism; neonatal hypoglycemia; postnatal; risk factors