An Update on Neonatal Hypoglycemia

摘要: Glucose is the predominant source of energy for fetal and neonatal brain. During process adaptation from a continuous supply glucose in-utero to an intermittent after birth, neonate prone periods low blood glucose. Transient mild decreases in levels are common feature perinatal adaptation. This period characterized by up-regulation hormonal metabolic pathways gluconeogenesis, hepatic glycogenolysis ketogenesis. However, some neonates, these may be delayed hypoglycemia get prolonged or severe. Persistent, recurrent severe cause irreversible injury developing Hence, neonatologist needs proactive suspecting, diagnosing treating newborn. The normal range different each newborn depends upon birthweight, gestational age, body stores, feeding status, availability sources as well presence absence disease. Population based meta-analyses have revealed that rise with increasing post natal age. Although, there controversies surrounding definition, <40 mg/dL considered operational threshold treat all neonates first few days life, irrespective gestation. Hypoglycemia most disorder intensive care unit. reported incidence varies population, measurement technique schedule. Preterm infants those intrauterine growth retardation at high risk week life because lack sufficient glycogen fat which normally accumulated third trimester. In preterm infants, developmental delays postnatal enzymes homeostasis persist even time discharge hospital. Large age diabetic mothers other important groups relative hyperinsulinemia. A proportion small also insulin contribute can weeks months. Recently, late (340/7 366/7weeks) been identified another group hypoglycemia. addition, any sick warrants screening Term healthy without factors need not monitored routinely. All asymptomatic, at-risk should screened two hours birth surveillance continued 4-6 hourly thereafter, until feedings established values normalized; take 48-72 hours. Monitoring before 2