Elaine Christine Dantas Mois
Posters: J Diabetes Metab
Introduction: Recurrent hyperinsulinemic hypoglycemia is an unusual metabolic disorder which can result in adverse perinatal outcome when it affects pregnant women. History and clinical findings: A 21 year-old pregnant woman, first pregnancy, forwarded to prenatal follow-up in tertiary center due to frequent episodes of hypoglycemia history since she was three months old, with worsening during the first half of pregnancy. Investigation and diagnosis: Clinical research showed frequent episodes of hypoglycemia, reaching levels corresponding to 18 mg%, accompanied by hyperinsulinemia. The image analysis using ultrasound and nuclear magnetic resonance were negative, suggesting the diagnosis of hyperplasia of pancreatic beta cells. Treatment and course: The management was carried out through nutritional support, accompanied by glucose monitoring and daily analysis of fetal vitality, plus daily prescription of Diazoxide 75 mg and 15 mg prednisone, both orally. Patient evolved with satisfactory glycemic control until 35 weeks of gestational age, when it was indicated resolution of pregnancy by a progressive decrease in plasma glucose levels. The male newborn presented birth weight of 2330 grams, Apgar Score of 9 and 10 at one minute and five minutes of life, respectively. He was discharged from the University General Hospital, Medical School of Ribeir?o Preto of University of S?o Paulo together with her mother with ten days of life. Patient refused pancreatic surgery as definitive treatment, opting for long-term clinical follow-up. Conclusion: Hypoglycemia secondary to hyperinsulinemia by pancreatic cell hyperplasia is a rare entity, which requires careful maternal and fetal monitoring, because of its complications. Drug management during pregnancy is possible, improving perinatal outcomes.
Elaine Christine Dantas Mois?s has completed her PhD in 2008 from the Ribeir?o Preto Medical School, University of S?o Paulo. She is a professor in the Department of Gynecology and Obstetrics of this institution. Her work has an emphasis on the following themes: Pharmacokinetics of drugs in pregnant women, placental transfer of drugs, Diabetes Mellitus in pregnant women.
