Transient Neonatal Hyperinsulinemia: Timely Diagnosis and Treatment

  • Megha P Postgraduate,Division of Neonatology, Department of Paediatrics, Bapuji Child Health Institute, JJM Medical College & RC, Davangere, Karnataka, India.
  • Ashwini RC Associate Professor, Division of Neonatology, Department of Paediatrics, Bapuji Child Health Institute, JJM Medical College & RC, Davangere, Karnataka, India.
Keywords: Persistent Hypoglycaemia, Refractory Hypoglycaemia, Hyperinsulinism, Diazoxide


Hyperinsulinism (HI) is the leading cause of persistent hypoglycaemia in newborns. Diazoxide inhibits the secretion of insulin and is the first-line drug for controlling hypoglycaemia secondary to prolonged transient hyperinsulinemia or permanent hyperinsulinemia, thus it prevents hypoglycaemia and the permanent neurological sequelae associated with hypoglycaemia. We report two neonates who presented with hypoglycaemia which was refractory. Investigations revealed hyperinsulinism and both neonates responded to treatment with oral diazoxide. Timely screening and prompt treatment of hypoglycaemia are recommended as it is linked to poor neuro developmental outcomes in the long term.

How to cite this article:
Megha P, Ashwini RC. Transient Neonatal Hyperinsulinemia: Timely Diagnosis and Treatment. Postgrad J Pediatr Adol Med. 2022;1(1):59-61.


Kallem VR, Pandita A, Pillai A. Infant of diabetic mother: what one needs to know? J Matern Fetal Neonatal Med. 2020;33:482-92. [PubMed] [Google Scholar]

Jain A, Aggarwal R, Jeevasanker M, Agarwal R, Deorari AK, Paul VK. Hypoglycemia in the newborn. Indian J Pediatr. 2008;75:63-7. [PubMed] [Google Scholar]

Shah R, Harding J, Brown J, McKinlay C. Neonatal glycemia and neurodevelopmental outcomes: a systematic review and meta-analysis. Neonatology. 2019;115:116-26. [PubMed] [Google Scholar]

Falzone N, Harrington J. Clinical predictors of transient versus persistent neonatal hyperinsulinism. Horm Res Paediatr. 2020;93:297-303. [PubMed] [Google Scholar]

Brar PC, Heksch R, Cossen K, De Leon DD, Kamboj MK, Marks SD, Marshall BA, Miller R, Page L, Stanley T, Mitchell D, Thornton P. Management and appropriate use of diazoxide in infants and children with hyperinsulinism. J Clin Endocrinol Metab. 2020;105:543. [PubMed] [Google Scholar]

Gray KD, Dudash K, Escobar C, Freel C, Harrison T, McMillan C, Puia-Dumitrescu M, Cotton CM, Benjamin R, Clark RH, Benjamin Jr DK, Greenberg RG; Best Pharmaceuticals for Children Act-Pediatric Trials Network Steering Committee. Prevalence and safety of diazoxide in the neonatal intensive care unit. J Perinatol. 2018;38:1496-502. [PubMed] [Google Scholar]

Hu S, Xu Z, Yan J, Liu M, Sun B, Li W, Sang Y. The treatment effect of diazoxide on 44 patients with congenital hyperinsulinism. J Pediatr Endocrinol Metab. 2012;25:1119-22. [PubMed] [Google Scholar]

Davidov AS, Elkon-Tamir E, Haham A, Shefer G, Weintrob N, Oren A, Lebenthal Y, Mandel D, Eyal O. Higher C-peptide levels and glucose requirements may identify neonates with transient hyperinsulinism hypoglycemia who will benefit from diazoxide treatment. Eur J Pediatr. 2020;179:597-602. [PubMed] [Google Scholar]

Balachandran B, Mukhopadhyay K, Sachdeva N, Walia R, Attri SV. Randomised controlled trial of diazoxide for small for gestational age neonates with hyperinsulinaemic hypoglycaemia provided early hypoglycaemic control without adverse effects. Acta Paediatr. 2018;107:990-5. [PubMed] [Google Scholar]