Yenidoğan hipoglisemisinde hiperinsülizmin yeri
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Date
2003-04-19
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Uludağ Üniversitesi
Abstract
Neonatal hipoglisemi bir çok nedene bağlı olarak ortaya çıkan, mortalite ve morbiditeyi önemli ölçüde artıran ciddi bir sorundur. Bu nedenle acil ve spesifik tedavinin en kısa zamanda başlatılması gerekmektedir. Bu çalışmada yenidoğan yoğun bakım ünitemizde Mayıs 1995-Nisan 2000 döneminde izlenen 111 hastanın demografik, antropometrik ve hormonal özelliklerini, hipoglisemiye neden olan etyolojik faktörleri, kullanılan tedavi yöntemlerini ve hastaların tedaviye yanıtını araştırmayı amaçladık. Bebeklerin %57’si erkek %43’ü kızdı. Ortalama doğum ağırlığı 3461±876 gram olup olguların %25’i düşük doğum ağırlığına (LBW), %42’si yüksek doğum ağırlığına (HBW) sahiptiler. Yine bebeklerin %12’si gebelik yaşına göre küçük (SGA), %44’ü gebelik yaşına göre büyük (LGA) bulundu. Annelerin %37’sinde gestasyonel diyabet, %6’sında tip I diyabet, %2’inde tip II diyabet mevcuttu. Gestasyonel diyabeti olan annelerin %71’i gebelik esnasında insülin tedavisine gereksinim duydular. Bebeklerin %61’inde hipoglisemi esnasında alınan kan örneklerinde hiperinsülinizm saptandı. Dekstroz infüzyonuna ilaveten olguların %31’i prednizolon, %14’ü ise prednizolonla birlikte diazoksit tedavisine gereksinim duydular. Sonuç olarak neonatal hipoglisemide hiperinsülinizm önemli bir etkendir, hipoglisemi esnasında alınan kan örneğinde rutin olarak aranmalı ve tedavi planı ona göre düzenlenmelidir.
Neonatal hypoglycemia, caused by a number of factors, is one of the important problems remarkably increasing the mortality and morbidity in newborns. Therefore, both urgent interventions and specific treatments should be commenced immediately. In this study, we aimed to investigate the demographic, anthropometric, and hormonal characteristics of hypoglycemic newborns, the etiological factors of hypoglycemia, our treatment modalities and the responses to the treatments in 111 newborns followed in our neonatal intensive care unit. Of the newborns, 57% were male, 43% were female; mean birth weight was 3461 ±876 grams; 25% had low birth weight (LBW), 42% had high birth weight, 12% were small for gestational age (SGA), and 44% were large for gestational age (LGA). Of the mothers, 37% had gestational diabetes, 6% had type 1 diabetes, and 2% had type 2 diabetes. 71% of the mothers with gestational diabetes required insulin treatment. We found that 61% of the hypoglycemic newborns had hyperinsulinism during hypoglycemic episodes; and of them, 31% and 14% required corticosteroid and diazoxide treatments, respectively. We conclude that hyperinsulinism plays an important role in neonatal hypoglycemia and the insulin concentrations should routinely be measured in critical blood samples obtained during hypoglycemia.
Neonatal hypoglycemia, caused by a number of factors, is one of the important problems remarkably increasing the mortality and morbidity in newborns. Therefore, both urgent interventions and specific treatments should be commenced immediately. In this study, we aimed to investigate the demographic, anthropometric, and hormonal characteristics of hypoglycemic newborns, the etiological factors of hypoglycemia, our treatment modalities and the responses to the treatments in 111 newborns followed in our neonatal intensive care unit. Of the newborns, 57% were male, 43% were female; mean birth weight was 3461 ±876 grams; 25% had low birth weight (LBW), 42% had high birth weight, 12% were small for gestational age (SGA), and 44% were large for gestational age (LGA). Of the mothers, 37% had gestational diabetes, 6% had type 1 diabetes, and 2% had type 2 diabetes. 71% of the mothers with gestational diabetes required insulin treatment. We found that 61% of the hypoglycemic newborns had hyperinsulinism during hypoglycemic episodes; and of them, 31% and 14% required corticosteroid and diazoxide treatments, respectively. We conclude that hyperinsulinism plays an important role in neonatal hypoglycemia and the insulin concentrations should routinely be measured in critical blood samples obtained during hypoglycemia.
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Keywords
Hipoglisemi, Hiperinsülinizm, Yenidoğan, Hypoglycemia, Hyperinsulinism, Newborn
Citation
Sağlam, H. vd. (2004). "Yenidoğan hipoglisemisinde hiperinsülizmin yeri". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 30(1), 31-35.