Diazoxide in your NICU?

[EvilAngelfish]

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Hi Friends,
In my NICU it seems like we have been using diazoxide more and more to treat persistent hypoglycemia in our preterm babies. We never used this medication during residency (we just didn't see this issue that often) and I'm wondering if it's just a shift in the patient population or is it really more common. Do you guys find yourselves treating with diazoxide a lot?

 

[takk]

Yes, I see it a lot in our "stress hyperinsulinism" kids we just can't get off of a GIR (but am at a center with a very large HI program, so our population is skewed)

 

[mvenus929]

Based on a single discussion I had with someone recently, I think in general, hypoglycemia is being treated more aggressively in infants, with some endos advocating for normal glucoses, rather than the 'lower' ones we allow in infants. Personally, I don't see it used that commonly in our NICU, but we also don't see a ton of hypoglycemia in our preemies because we are so aggressive with their nutrition early on.

 

[ChipperChop]

I come from a middle sized residency/institution and I never used diazoxide not once. In my endo fellowship, it's a daily consult!

 

[NeoN8L]

Be aware of the risk of pulmonary hypertension developing in babies receiving diazoxide. I no longer use diazoxide, focusing more on advancing enteral feeds. The first time I used it (at the behest of the endocrinologist), the baby developed severe PPHN. Following that, I would get a screening echo prior to starting the drug, then monitor weekly while on the drug. I stopped using diazoxide soon after that as I was consistently seeing pulmonary hypertension develop when on diazoxide.