Somatostatin analogue in the treatment of transient hyperinsulinemic hypoglycemia of the newborn

We report a preliminary study of somatostatin analogue in the treatment of 2 cases of transient hyperinsulinemic hypoglycemia of the newborn. Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) was suspected in the first case and infant of diabetic mother in the second case. Diagnosis of hyperinsulinemia was made on combined laboratory findings as follows; high glucose infusion rate (13-15 mg/kg/min), high insulin (17-33 μU/ml), high insulin/glucose ratio (0.4-0.8) and no ketogenic response against hypoglycemia. Blood glucose value rose rapidly and stabilized and insulin level were normalized after 5 μg/kg of somatostatin analogue was administrated subcutaneously every 8 hours. We tapered the glucose infusion rate and discontinued somatostatin analogue within 3 weeks. No adverse effect was found during the therapeutic course. We believe that somatostatin analogue is a safe and effective drug for transient hyperinsulinemic hypoglycemia of the newborn and may be an alternative of prolonged high dose glucose infusion.