-
Clinical Endocrinology Feb 2024
Topics: Humans; Diazoxide; Hyperinsulinism; Hypoglycemia; Congenital Hyperinsulinism
PubMed: 38059613
DOI: 10.1111/cen.14991 -
Pediatric Cardiology Aug 2017Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide... (Review)
Review
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. In July 2015, the FDA issued a drug safety communication warning that pulmonary hypertension (PH) had been reported in 11 infants being treated with diazoxide and that the PH resolved with withdrawal of diazoxide. All three of the cases in our hospital were admitted to the neonatal intensive care unit (NICU) for hypoglycemia. All patients received thorough radiologic and laboratory evaluations related to their diagnosis of CHI. All initially improved when diazoxide was initiated. Case 1 and case 3 were discharged from the NICU on diazoxide and chlorothiazide. Case 2 developed pulmonary hypertension while still in the NICU days after an increase in diazoxide dosing. Case 1 presented to the emergency room in respiratory distress shortly after discharge from the NICU with evidence of PH and heart failure. Case 3 presented to the emergency room after 2 weeks at home due to a home blood glucose reading that was low and developed PH and heart failure while an inpatient. Discontinuation of diazoxide led to resolution of all three patients' PH within approximately one week. The experience of our hospital indicates that pulmonary hypertension may be more common than previously thought in infants taking diazoxide. It is unclear if these symptoms develop slowly over time or if there is some other, as yet undescribed, trigger for the pulmonary hypertension. Our hospital's experience adds to the body of evidence and suggests these infants may benefit from more surveillance with echocardiography.
Topics: Congenital Hyperinsulinism; Diazoxide; Humans; Hypertension, Pulmonary; Infant, Newborn; Insulin Antagonists; Male
PubMed: 28642988
DOI: 10.1007/s00246-017-1652-3 -
East African Medical Journal Jul 1976
Review
Topics: Adolescent; Adult; Diazoxide; Female; Humans; Hypertension; Male; Middle Aged; Pregnancy; Vasomotor System
PubMed: 795632
DOI: No ID Found -
Gynecological Endocrinology : the... Jun 2022Safety information on diazoxide for pregnant and lactating women with hypoglycemia is limited. In this case report, we assessed diazoxide concentrations in maternal and...
Safety information on diazoxide for pregnant and lactating women with hypoglycemia is limited. In this case report, we assessed diazoxide concentrations in maternal and infant blood, cord blood, and breast milk. We described a 30-year-old pregnant woman diagnosed with hypoglycemia due to nesidioblastosis at 4 months of age. Before becoming pregnant, she was treated with oral diazoxide (75-375 mg). All medications were discontinued after she was discovered to be pregnant. During gestational week 25, diazoxide treatment was resumed at 150-175 mg daily for repeated hypoglycemic episodes. Diazoxide administration was continued in combination with diet treatment until delivery. Glucose levels were well controlled. During gestational week 40, a male infant weighing 3069 g was delivered spontaneous vaginal delivery with no pregnancy or neonatal complications. Diazoxide concentrations detected in maternal serum at 2.5-11.6 h after oral treatment ranged from 12.4 to 32.7 µg/mL. In cord blood, the diazoxide concentration was 18.5 µg/mL at 7.2 h after the last dose. During lactation, no hypoglycemia or hyperglycemia was observed. The approximate calculated ratio of diazoxide in breast milk and maternal serum was 0.09. The calculated daily infant dose was 0.47 mg/kg/day. The relative infant dose breast milk ranged from 3.1% to 5.9%. Diazoxide transferred from maternal blood to the fetus across the placenta. It also transferred into breast milk, but there were no harmful effects on the infant.
Topics: Adult; Diazoxide; Female; Fetal Blood; Humans; Hypoglycemia; Infant; Infant, Newborn; Lactation; Male; Milk, Human; Pregnancy
PubMed: 35403531
DOI: 10.1080/09513590.2022.2061453 -
The Journal of Clinical Endocrinology... Jun 2024
Topics: Humans; Diazoxide; Congenital Hyperinsulinism; Infant, Newborn; Drug Resistance
PubMed: 38104245
DOI: 10.1210/clinem/dgad741 -
British Medical Journal Nov 1971
Topics: Diazoxide; Humans; Hypotension; Hypotension, Orthostatic; Methyldopa
PubMed: 5128223
DOI: 10.1136/bmj.4.5786.560-c -
Archives of Disease in Childhood Jul 1992
Topics: Child, Preschool; Diazoxide; Humans; Hyperinsulinism; Hypoglycemia; Infant; Orphan Drug Production
PubMed: 1519969
DOI: 10.1136/adc.67.7.980-a -
Obesity (Silver Spring, Md.) Feb 2024This study assessed the effect of 1-year administration of diazoxide choline extended-release tablet (DCCR) on hyperphagia and other complications of Prader-Willi...
OBJECTIVE
This study assessed the effect of 1-year administration of diazoxide choline extended-release tablet (DCCR) on hyperphagia and other complications of Prader-Willi syndrome (PWS).
METHODS
The authors studied 125 participants with PWS, age ≥ 4 years, who were enrolled in the DESTINY PWS Phase 3 study and who received DCCR for up to 52 weeks in DESTINY PWS and/or its open-label extension. The primary efficacy endpoint was Hyperphagia Questionnaire for Clinical Trials (HQ-CT) score. Other endpoints included behavioral assessments, body composition, hormonal measures, and safety.
RESULTS
DCCR administration resulted in significant improvements in HQ-CT (mean [SE] -9.9 [0.77], p < 0.0001) and greater improvements in those with more severe baseline hyperphagia (HQ-CT > 22). Improvements were seen in aggression, anxiety, and compulsivity (all p < 0.0001). There were reductions in leptin, insulin, and insulin resistance, as well as a significant increase in adiponectin (all p < 0.004). Lean body mass was increased (p < 0.0001). Disease severity was reduced as assessed by clinician and caregiver (both p < 0.0001). Common treatment-emergent adverse events included hypertrichosis, peripheral edema, and hyperglycemia. Adverse events infrequently resulted in discontinuation (7.2%).
CONCLUSIONS
DCCR administration to people with PWS was well tolerated and associated with broad-ranging improvements in the syndrome. Sustained administration of DCCR has the potential to reduce disease severity and the burden of care for families.
Topics: Humans; Child, Preschool; Prader-Willi Syndrome; Diazoxide; Hyperphagia; Body Composition; Insulin
PubMed: 37919617
DOI: 10.1002/oby.23928 -
Journal of the Medical Association of... Nov 1973
Topics: Diazoxide; Emergencies; Humans; Hypertension; Injections, Intravenous
PubMed: 4760620
DOI: No ID Found -
Journal of the Tennessee Medical... Apr 1976
Topics: Adolescent; Adult; Aged; Diazoxide; Female; Humans; Hypertension; Male; Middle Aged
PubMed: 1263494
DOI: No ID Found