TY - JOUR T1 - Safety and efficacy of low-dose diazoxide in small-for-gestational-age infants with hyperinsulinaemic hypoglycaemia JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - 359 LP - 363 DO - 10.1136/archdischild-2021-322845 VL - 107 IS - 4 AU - Suresh Chandran AU - Pravin R R AU - Chua Mei Chien AU - Seyed Ehsan Saffari AU - Victor Samuel Rajadurai AU - Fabian Yap Y1 - 2022/07/01 UR - http://fn.bmj.com/content/107/4/359.abstract N2 - Objectives Diazoxide (DZX) is the drug of choice for treating hyperinsulinaemic hypoglycaemia (HH), and it has potentially serious adverse effects. We studied the safety and efficacy of low-dose DZX in small-for-gestational-age (SGA) infants with HH.Design An observational cohort study from 1 September 2014 to 31 September 2020.Setting A tertiary Women’s and Children’s Hospital in Singapore.Patients All SGA infants with HH.Intervention Diazoxide, at 3–5 mg/kg/day.Main outcome measures Short-term outcomes; adverse drug events and fasting studies to determine ‘safe to go home’ and ‘resolution’ of HH.Results Among 71 836 live births, 11 493 (16%) were SGA. Fifty-six (0.5%) SGA infants with HH were identified, of which 27 (47%) with a mean gestational age of 36.4±2 weeks and birth weight of 1942±356 g required DZX treatment. Diazoxide was initiated at 3 mg/kg/day at a median age of 10 days. The mean effective dose was 4.6±2.2 mg/kg/day, with 24/27 (89%) receiving 3–5 mg/kg/day. Generalised hypertrichosis occurred in 2 (7.4%) and fluid retention in 1 (3.7%) infant. A fasting study was performed before home while on DZX in 26/27 (96%) cases. Diazoxide was discontinued at a median age of 63 days (9–198 days), and resolution of HH was confirmed in 26/27 (96%) infants on passing a fasting study.Conclusion Our study demonstrates that low-dose DZX effectively treats SGA infants with HH as measured by fasting studies. Although the safety profile was excellent, minimal adverse events were still observed with DZX, even at low doses.Data are available on reasonable request. The data that support the findings of this study are available from the corresponding author on reasonable request. ER -