Halil İbrahim YAKUT, Mehmet Yekta ÖNCEL, Fuat Emre CANPOLAT, Nurdan URAŞ, Nilüfer OKUR, Mehmet BÜYÜKTİRYAKİ, Şerife Suna OĞUZ

Yenidoğan Döneminde Hiperinsülinemik Hipoglisemi Tanısı Alan Hastaların Farmokolojik Tedavi Yaklaşımına Göre Değerlendirilmesi: Tek Merkez Deneyimi

Amaç: Hiperinsülinizmin infantlarda persistan ve tekrarlayan hipogliseminin en sık nedenidir. Bu çalışmamızın amacı hiperinsülinemik hipoglisemi tanısı alan hastaları tedavi ihtiyaçlarına göre gruplandırmak ve kısa dönem prognozlarını araştırmaktır.Gereç ve Yöntemler: Ocak 2012-Ocak 2015 tarihleri arasında Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Yenidoğan Yoğun Bakım ünitesinde yatan ve hiperinsülinemik hipoglisemi tanısı alan hastalar çalışmaya dahil edildi.Bulgular: Diazoksit ile kombine tedavi grubu karşılaştırıldığında insülin, glukoz, insülin/glukoz oranı, en yüksek dekstroz ihtiyacı, hipoglisemi kontrol zamanı ve hastanede yatış süreleri açısından istatistiksel bir farklılık görülmedi p>0.05 .Sonuç: Yenidoğanda hiperinsülinemik hipoglisemi, nörolojik hasarı önlemek için acil ve etkin tedavi edilmesi gereken bir durumdur. Hiperinsülinemik hipoglisemi yenidoğanlarda normoglisemiyi sağlamak için yüksek konsantrasyonda glukoz infüzyonu yapılması ve erken dönemde ilaç tedavisi başlanması gerekmektedir. İlk seçenek tedavi olan diazoksit etkindir ve iyi tolere edilmektedir.

Anahtar Kelimeler:

Hiperinsulinizm, hipoglisemi, diazoksit, yenidoğan

Evaluation Of Neonatal Hyperinsulinemic Hypoglycemia According To Pharmacological Treatment Approach: Single Center Experience

Aim: Hyperinsulinism is the most common cause of persistent and recurrent hypoglycaemia in newborn. The aim of this study was to evaluate patients who were diagnosed with hyperinsulinemic hypoglycemia retrospectively.Material and Methods: Patients’ records that were admitted to Zekai Tahir Burak Women’s Health Education and Research Hospital Neonatal Intensive Care Unit to between January 2012 and January 2015 were overviewed.Results: Levels of insulin and glucose, insulin/glucose ratio, the highest glucose infusion rates, time of recovery from hypoglycemia and duration of hospitalization were similar between diazoxide monotherapy group and combined multi-therapy group p>0.05 .Conclusion: Hyperinsulinemic hypoglycemia in the newborn period should be immediately and effectively treated to prevent further neurological damage. Maintaining normoglycemia with appropriate glucose infusion rates and early pharmacologic treatment is essential. Diazoxide is an effective and well-tolerated option as first line therapy in newborn hypoglycemia.

Keywords:

Hyperinsulinism, hypoglycemia, diazoxide, newborn,

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