NEONATAL HYPOGLYCEMIA: A CONTINUING DEBATE IN DEFINITION AND MANAGEMENT
Journal
Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)
Date Issued
2015-12
Author(s)
Elizabeta Petkovska
Snezana Jancevska
Abstract
Neonatal hypoglycemia (NH) is one of the most common abnormalities encountered in the newborn.
Maintaining glucose homeostasis is one of the important physiological events during fetal-to-neonatal transition. Transient low blood glucose concentrations are frequently encountered in the majority of healthy newborns and are the reflections of normal metabolic adaptation processes. Nevertheless, there is a great concern that prolonged or recurrent low blood glucose levels may result in
long-term neurological and developmental consequences.
Strikingly, it was demonstrated that the incidence and timing of low glucose concentrations in the
groups most at risk for asymptomatic neonatal hypoglycemia, did not find association between repetitive low glucose concentrations and poor neurodevelopmental outcomes. On the contrary, NH due
to hyperinsulinism is strongly associated with brain injury.
Fundamental issue of great professional controversy is concerning the best manner to manage
asymptomatic newborns NH. Both, overtreating NH and undertreating NH are poles with significant
potential disadvantages.
Therefore, NH is one of the most important issues in the day-to-day practice. This article appraises
the critical questions of definition (widely accepted blood glucose concentration: < 2.6 mmol/l or
47 mg/dl), follow-up ad management of NH
Maintaining glucose homeostasis is one of the important physiological events during fetal-to-neonatal transition. Transient low blood glucose concentrations are frequently encountered in the majority of healthy newborns and are the reflections of normal metabolic adaptation processes. Nevertheless, there is a great concern that prolonged or recurrent low blood glucose levels may result in
long-term neurological and developmental consequences.
Strikingly, it was demonstrated that the incidence and timing of low glucose concentrations in the
groups most at risk for asymptomatic neonatal hypoglycemia, did not find association between repetitive low glucose concentrations and poor neurodevelopmental outcomes. On the contrary, NH due
to hyperinsulinism is strongly associated with brain injury.
Fundamental issue of great professional controversy is concerning the best manner to manage
asymptomatic newborns NH. Both, overtreating NH and undertreating NH are poles with significant
potential disadvantages.
Therefore, NH is one of the most important issues in the day-to-day practice. This article appraises
the critical questions of definition (widely accepted blood glucose concentration: < 2.6 mmol/l or
47 mg/dl), follow-up ad management of NH
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