Diazoxide is used in the treatment of neonatal hyperinsulinaemic hypoglycaemia (HH) as it is an inhibitor of pancreatic insulin production. It also causes smooth muscle relaxation, and has been shown to disrupt intestinal motility in animal models.(1) An independent association has recently been suggested between neonatal diazoxide treatment and the occurrence of necrotising enterocolitis (NEC).(2) We are currently conducting a large multi-site study in order to verify this putative association. To start with, we hypothesise that differential diazoxide treatment rates for HH between hospitals may affect any diazoxide-NEC association, and would therefore require independent consideration within our larger association study.
The aim of this study is to determine the diazoxide treatment prevalence at an Australian centre, and to compare this to published international diazoxide treatment rates.
All infants aged 0-1 year who were exposed to diazoxide over the 15-year period from 1 January 2007 to 31 December 2021 at the Monash Children’s Hospital neonatal intensive care unit were included. There were 30 293 infants studied, with 31 receiving diazoxide treatment for HH (0.10%). This treatment rate is similar to most published incidence rates, ranging from 0.04% in Singapore(3) to 0.09% in the United States(4). However, notably these published treatment rates are all significantly lower than the 0.36% diazoxide treatment rate reported in the Canadian study where the diazoxide-NEC association was found.(2)
This data suggests that variation in practice exists among international centres in rates of diazoxide use. This variation may be associated with differences in patient population or clinical practice. We will analyse diazoxide treatment rates within our ongoing multi-centre analysis of diazoxide-NEC association. Given this preliminary data, it would be very important to ascertain any association between high rates of diazoxide use and increased NEC incidence.