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Analysis Study Research Paper | Pediatrics and Child Health | India | Volume 14 Issue 4, April 2025 | Popularity: 5 / 10
Transient Hyperinsulinemic Hypoglycemia in Small for Gestational Age Infants in a Tertiary Care Hospital - A Retrospective Analysis
Navya A, Giridhar S, Meena K
Abstract: Aim: To study the clinical profile and course of hyperinsulinemic hypoglycemia (HH) in small for gestational age (SGA) infants. Methods: A Retrospective analysis of all SGA infants admitted in the neonatal unit of our hospital between February 2023 and June 2024 was done. The cases were SGA infants diagnosed with hyperinsulinemia (HI), and these were compared with the other SGA infants without HI. The antenatal and birth characteristics of the groups were compared, and the clinical profile and outcomes of the HH infants were described. Results: Seven cases of HH were identified among 174 hypoglycemic SGA infants (4%). The mean gestational age of the HH group was 38weeks and birth weight 1926grams, whereas the mean gestational age and birth weight of the other SGA infants was 37weeks and 2030grams respectively. There was no difference in the antenatal and birth characteristics of the 2 groups. The HH infants developed hypoglycemia (blood glucose < 40 mg/dl) from <1 hour to 50 hours of life. These infants were evaluated for hyperinsulinemia when the need for glucose infusion was > 6 mg/kg/min and persisted for >7 days. Hyperinsulinemia was diagnosed if plasma insulin levels was >2?U/ml when plasma glucose was <50mg/dl. The mean insulin level was 19.7?U/ml during hypoglycemia. Three infants received diazoxide and one received octreotide. Infants receiving drug therapy were weaned off intravenous glucose between 2.5 and 7 days after starting therapy and drugs were successfully withdrawn between 15 and 48 days of life (mean 31.5 days). In 3 infants, glucose requirement spontaneously decreased between 8.5 and 12 days, without requiring specific drug therapy. Conclusion: This study on transient HH in SGA infants, suggests that hyperinsulinemia in hypoglycemic SGA infants is not uncommon. No difference in the antenatal and birth characteristics were seen in the HH infants compared to the other SGA infants. Response to diazoxide/octreotide could indicate transient HH and successful withdrawal of drug therapy could be made.
Keywords: Infant, Small for Gestational Age, Hyperinsulinism, Hypoglycemia, Diazoxide, Octreotide
Edition: Volume 14 Issue 4, April 2025
Pages: 642 - 646
DOI: https://www.doi.org/10.21275/SR25303185223
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