Endocrine Abstracts

Background: Diazoxide is the only oral treatment used in the management of Congenital Hyperinsulinism (CHI). While the liquid formulation (Proglycem®) is commonly prescribed, it poses challenges due to high cost and limited availability in primary and secondary care. Most patients under our care receive prescriptions directly from our service creating a dependency on tertiary services. We aimed to transition eligible patients (aged ≥7 years) from the liquid to tablet formulation, improving access, reducing costs, and supporting independent prescribing in primary care.

Methods: We identified eligible patients currently receiving diazoxide liquid. A multidisciplinary team (MDT) developed a standardized dose conversion guide and educational materials for patients and families to facilitate the transition. Additional support from play specialists and psychology was offered where appropriate. We worked with pharmacy to secure a stable supply of diazoxide tablets and created a contingency plan for unlicensed capsule use.

Results: 19 eligible patients were identified on retrospective review of our patient cohort. To date, 10 have successfully transitioned to tablets/capsules. Patient and caregiver education materials, including tablet-swallowing training, were developed and implemented. Early findings show maintained glycaemic control, no adverse events, and improved prescribing efficiency. Projected cost savings are estimated at ≥75%. This project is ongoing, with positive feedback from families and improved prescribing sustainability.

Conclusion: The structured transition from diazoxide liquid to tablet formulation demonstrates a safe, effective, and sustainable approach for managing CHI in older children. It reduces tertiary centre dependency, empowers families, supports GP prescribing, and achieves significant cost savings without compromising patient care.