Diazoxide In the Management Of Hypoglycemic Neonates

NCT ID: NCT00994149

Last Updated: 2009-10-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-10-31

Study Completion Date

2011-10-31

Brief Summary

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Diazoxide is an oral hyperglycemic medication. Diazoxide has been proven effective for treating hypoglycemia in infants and children with some types of persistent hyperinsulinemic hypoglycemia. The mechanism of action results in decreased insulin secretion. One of the causes of hypoglycemia in infants of diabetic mothers occurs due to a transient hyperinsulinemic state postnatally. The investigators have clinical experience and success using diazoxide in their unit for patients with hypoglycemia not adequately managed with intravenous (iv) dextrose and enteral supplementation. In this randomized controlled study the investigators expect that by using diazoxide as the initial treatment for infants of diabetic mothers with asymptomatic hypoglycemia (blood glucose of 2.5 to 2.0mmol/L), the investigators will be able to decrease the number of infants requiring an intravenous by at least thirty percent.

Detailed Description

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Conditions

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Infant, Newborn, Diseases Pregnancy in Diabetics Infant, Diabetic Mother Hypoglycemia Infant, Large for Gestational Age

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Diazoxide

Infants in this are will receive 10mg/kg/d of diazoxide divided and given every eight hours

Group Type EXPERIMENTAL

Diazoxide

Intervention Type DRUG

10mg/kg/d divide every 8 hours

Ora-plus

Liquid suspension modified to match intervention. Given every eight hours. Provided in shielded syringes.

Group Type PLACEBO_COMPARATOR

Ora-plus

Intervention Type DRUG

placebo, give every 8 hours.

Interventions

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Diazoxide

10mg/kg/d divide every 8 hours

Intervention Type DRUG

Ora-plus

placebo, give every 8 hours.

Intervention Type DRUG

Other Intervention Names

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Brand Name: Proglycem

Eligibility Criteria

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Inclusion Criteria

* Infants of diabetic mothers (IDMs) or infants weighing \>90%
* Hypoglycemia: two consecutive blood glucose measurements \<2.6mol/L and \>1.9mmol/L in the first twelve hours of life
* \> 36 weeks gestational age

Exclusion Criteria

* Infants with symptomatic hypoglycemia (regardless of value
* Infants who meet criteria for intravenous dextrose according to the Canadian Pediatric Society (CPS) position statement
* Infants with contraindications for enteral feeds and/or medications
Maximum Eligible Age

12 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Saskatchewan

OTHER

Sponsor Role lead

Responsible Party

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University of Saskatchewan, Department of Pediatrics, Neonatal Research Group

Principal Investigators

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Koravangattu Sankaran, MD, BS, FRCPC, F.C.C.M.

Role: PRINCIPAL_INVESTIGATOR

University of Saskatchewan, Department of Pediatrics, Head of Neonatal Research Group

Locations

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Royal University Hospital

Saskatoon, Saskatchewan, Canada

Site Status

Countries

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Canada

Central Contacts

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Koravangattu Sankaran, MD, BS, FRCPC, F.C.C.M.

Role: CONTACT

1-306-966-8118

Jennifer M Toye, MD, FRCP(C)

Role: CONTACT

1-306-966-8118

Facility Contacts

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Koravangattu Sankaran, MD, FRCPC

Role: primary

1-306-966-8118

Carmen Dmytryshyn, RN

Role: backup

1-306-966-8138

References

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Screening guidelines for newborns at risk for low blood glucose. Paediatr Child Health. 2004 Dec;9(10):723-740. doi: 10.1093/pch/9.10.723. No abstract available.

Reference Type BACKGROUND
PMID: 19688086 (View on PubMed)

Stenninger E, Flink R, Eriksson B, Sahlen C. Long-term neurological dysfunction and neonatal hypoglycaemia after diabetic pregnancy. Arch Dis Child Fetal Neonatal Ed. 1998 Nov;79(3):F174-9. doi: 10.1136/fn.79.3.f174.

Reference Type BACKGROUND
PMID: 10194986 (View on PubMed)

Holtrop PC. The frequency of hypoglycemia in full-term large and small for gestational age newborns. Am J Perinatol. 1993 Mar;10(2):150-4. doi: 10.1055/s-2007-994649.

Reference Type BACKGROUND
PMID: 8476480 (View on PubMed)

Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward-Platt MP, Schwartz R, Kalhan SC. Controversies regarding definition of neonatal hypoglycemia: suggested operational thresholds. Pediatrics. 2000 May;105(5):1141-5. doi: 10.1542/peds.105.5.1141.

Reference Type BACKGROUND
PMID: 10790476 (View on PubMed)

Diwakar KK, Sasidhar MV. Plasma glucose levels in term infants who are appropriate size for gestation and exclusively breast fed. Arch Dis Child Fetal Neonatal Ed. 2002 Jul;87(1):F46-8. doi: 10.1136/fn.87.1.f46.

Reference Type BACKGROUND
PMID: 12091291 (View on PubMed)

Hoseth E, Joergensen A, Ebbesen F, Moeller M. Blood glucose levels in a population of healthy, breast fed, term infants of appropriate size for gestational age. Arch Dis Child Fetal Neonatal Ed. 2000 Sep;83(2):F117-9. doi: 10.1136/fn.83.2.f117.

Reference Type BACKGROUND
PMID: 10952705 (View on PubMed)

Hawdon JM. Hypoglycaemia and the neonatal brain. Eur J Pediatr. 1999 Dec;158 Suppl 1:S9-S12. doi: 10.1007/pl00014319.

Reference Type BACKGROUND
PMID: 10592092 (View on PubMed)

Stenninger E, Schollin J, Aman J. Early postnatal hypoglycaemia in newborn infants of diabetic mothers. Acta Paediatr. 1997 Dec;86(12):1374-6. doi: 10.1111/j.1651-2227.1997.tb14916.x.

Reference Type BACKGROUND
PMID: 9475319 (View on PubMed)

Nold JL, Georgieff MK. Infants of diabetic mothers. Pediatr Clin North Am. 2004 Jun;51(3):619-37, viii. doi: 10.1016/j.pcl.2004.01.003.

Reference Type BACKGROUND
PMID: 15157588 (View on PubMed)

DRASH A, WOLFF F. DRUG THERAPY IN LEUCINE-SENSITIVE HYPOGLYCEMIA. Metabolism. 1964 Jun;13:487-92. doi: 10.1016/0026-0495(64)90133-7. No abstract available.

Reference Type BACKGROUND
PMID: 14193979 (View on PubMed)

Agrawal RK, Lui K, Gupta JM. Neonatal hypoglycaemia in infants of diabetic mothers. J Paediatr Child Health. 2000 Aug;36(4):354-6. doi: 10.1046/j.1440-1754.2000.00512.x.

Reference Type BACKGROUND
PMID: 10940170 (View on PubMed)

Tyrrell VJ, Ambler GR, Yeow WH, Cowell CT, Silink M. Ten years' experience of persistent hyperinsulinaemic hypoglycaemia of infancy. J Paediatr Child Health. 2001 Oct;37(5):483-8. doi: 10.1046/j.1440-1754.2001.00748.x.

Reference Type BACKGROUND
PMID: 11885714 (View on PubMed)

Touati G, Poggi-Travert F, Ogier de Baulny H, Rahier J, Brunelle F, Nihoul-Fekete C, Czernichow P, Saudubray JM. Long-term treatment of persistent hyperinsulinaemic hypoglycaemia of infancy with diazoxide: a retrospective review of 77 cases and analysis of efficacy-predicting criteria. Eur J Pediatr. 1998 Aug;157(8):628-33. doi: 10.1007/s004310050900.

Reference Type BACKGROUND
PMID: 9727845 (View on PubMed)

Dunne MJ, Cosgrove KE, Shepherd RM, Aynsley-Green A, Lindley KJ. Hyperinsulinism in infancy: from basic science to clinical disease. Physiol Rev. 2004 Jan;84(1):239-75. doi: 10.1152/physrev.00022.2003.

Reference Type BACKGROUND
PMID: 14715916 (View on PubMed)

Shirland L. When it is more than transient neonatal hypoglycemia: hyperinsulinemia--a case study challenge. Neonatal Netw. 2001 Jun;20(4):5-11. doi: 10.1891/0730-0832.20.4.5.

Reference Type BACKGROUND
PMID: 12143902 (View on PubMed)

Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 14th edition. Hudson (OH): Lexi-comp, Inc. 2007: 485-6

Reference Type BACKGROUND

McGraw ME, Price DA. Complications of diazoxide in the treatment of nesidioblastosis. Arch Dis Child. 1985 Jan;60(1):62-4. doi: 10.1136/adc.60.1.62.

Reference Type BACKGROUND
PMID: 3970573 (View on PubMed)

Behrman RE, Kliegman R, Jenson HB, StantonBF. Nelson Textbook of Pediatrics 18th Edition. Philadelphia: WB Saunders Company 2007:783-6

Reference Type BACKGROUND

Other Identifiers

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HC Control Number: 126963

Identifier Type: -

Identifier Source: secondary_id

Bio-REB #08-151

Identifier Type: -

Identifier Source: org_study_id

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