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Recurrent Hypoglycemia in Two Late-Preterm Infants With Transitional Disorder of Glucose Mobilization-Case Series

Suresh Chandran1,2,3,4, Yu Shan Ting1, Skanthakumar Abhirami1

  • 1Department of Neonatology KK Women's and Children's Hospital Singapore.

Clinical Case Reports
|April 22, 2026
PubMed

Insights

Recurrent hypoglycemia in preterm infants can stem from temporary glucose mobilization issues, not hyperinsulinism. Diazoxide treatment and glucagon tests can help identify hepatic enzyme immaturity in these cases.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Metabolic Disorders

Background:

  • Recurrent hypoglycemia is a significant concern in at-risk infants.
  • Hyperinsulinism is a common cause, but other etiologies exist.

Purpose of the Study:

  • To report on two preterm infants with recurrent nonhyperinsulinemic hypoglycemia.
  • To highlight the role of transient glucose mobilization impairment.
  • To discuss the diagnostic utility of glucagon stimulation tests and genetic testing.

Main Methods:

  • Case report of two preterm infants.
  • Clinical evaluation including recurrent hypoglycemia assessment.
  • Glucagon stimulation test performance.
  • Genetic testing for glycogen storage disorders.

Main Results:

  • Both infants presented with recurrent nonhyperinsulinemic hypoglycemia.
  • Diagnosis was attributed to transient impairment of glucose mobilization.
  • Diazoxide was administered for treatment.
  • Inadequate response to glucagon stimulation suggested hepatic enzyme immaturity.
  • Genetic testing for glycogen storage disorders was negative.

Conclusions:

  • Transient impairment of glucose mobilization can cause recurrent hypoglycemia in preterm infants.
  • Diazoxide is a viable treatment option.
  • Glucagon stimulation tests and genetic testing aid in differentiating causes of hypoglycemia and identifying hepatic enzyme immaturity.

Keywords:
diazoxideglucagonhyperinsulinismhypoglycemiapretermsmall‐for‐gestational‐age

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