Related Experiment Video
Updated: Nov 30, 2025
19:15
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
87.1K
Clinical Predictors of Transient versus Persistent Neonatal Hyperinsulinism
Nicole Falzone1, Jennifer Harrington2,3
1Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Hormone Research in Paediatrics
|November 16, 2020
Summary
High birth weight in newborns predicts persistent hyperinsulinism (HI), a cause of hypoglycemia. Early genetic testing is recommended for better management and outcomes in these infants.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
Background:
- Hyperinsulinism (HI) is the leading cause of persistent neonatal hypoglycemia.
- HI can lead to extended hospital stays and potential long-term neurological issues.
- Distinguishing transient from persistent HI is vital for effective treatment.
Purpose of the Study:
- To determine if initial clinical and biochemical factors predict transient versus persistent HI.
- To analyze differences in hospital outcomes among HI subtypes.
- To identify predictors for diazoxide-unresponsive (DU) HI.
Main Methods:
- Retrospective review of 79 infants diagnosed with HI.
- Classification into three groups: transient HI, diazoxide-responsive persistent HI, and diazoxide-unresponsive (DU) persistent HI.
- Analysis of clinical data, birth weight, maternal history, and hospital outcomes.
Main Results:
- Infants with birth weight above the 90th percentile had an 8-fold increased risk of persistent HI and a 21-fold increased risk of DU HI.
- Most transient HI cases with high birth weight occurred in infants of mothers with gestational diabetes.
- Diazoxide-unresponsive HI cases showed significantly higher rates of gastrostomy tube insertion and longer hospital admissions.
Conclusions:
- Elevated birth weight, without maternal gestational diabetes, strongly indicates persistent HI.
- Expedited genetic testing is advised for infants with high birth weight and HI to guide clinical decisions.
- Differences in outcomes underscore the importance of early and accurate HI subtyping.
Related Concept Videos
01:20Pathophysiology of Diabetes
2.6K
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
2.6K
01:22Diabetes Mellitus: Type 2 and Gestational
4.0K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
4.0K
01:22Diabetes Mellitus: Overview and Type I Subtype
4.5K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
4.5K
01:15Hypoglycemia and Glucagon
651
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
651
01:15Diabetes: Symptoms, Diagnosis, and Complications
1.7K
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
1.7K
01:16Insulin: Dosing Regimen and Adverse Effects
488
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
488