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    Hypoglycemia in Neonates

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    Nashirah Frinzz Hauzi
    Neonatal hypoglycemia occurs when a newborn's blood sugar level drops below 2.6 mmol/L. It can be caused by too much insulin, not enough glycogen stores, or insufficient glucose production or intake by the baby. Transient hypoglycemia may be due to conditions like sepsis or being born to a diabetic mother. Decreased glycogen stores can result from prematurity, growth restriction, or insufficient caloric intake. Recurrent or persistent hypoglycemia may be from hyperinsulinism, hormone deficiencies, or inherited metabolic disorders. Symptoms range from none to jitteriness, cyanosis, and poor feeding. Treatment involves increasing glucose infusion rates and encouraging breastfeeding.

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    Hypoglycemia in Neonates

    Uploaded by

    Nashirah Frinzz Hauzi
    122 views23 pages
    Neonatal hypoglycemia occurs when a newborn's blood sugar level drops below 2.6 mmol/L. It can be caused by too much insulin, not enough glycogen stores, or insufficient glucose production or intake by the baby. Transient hypoglycemia may be due to conditions like sepsis or being born to a diabetic mother. Decreased glycogen stores can result from prematurity, growth restriction, or insufficient caloric intake. Recurrent or persistent hypoglycemia may be from hyperinsulinism, hormone deficiencies, or inherited metabolic disorders. Symptoms range from none to jitteriness, cyanosis, and poor feeding. Treatment involves increasing glucose infusion rates and encouraging breastfeeding.

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    Neonatal hypoglycemia occurs when a newborn's blood sugar level drops below 2.6 mmol/L. It can be caused by too much insulin, not enough glycogen stores, or insufficient glucose production or intake by the baby. Transient hypoglycemia may be due to conditions like sepsis or being born to a diabetic mother. Decreased glycogen stores can result from prematurity, growth restriction, or insufficient caloric intake. Recurrent or persistent hypoglycemia may be from hyperinsulinism, hormone deficiencies, or inherited metabolic disorders. Symptoms range from none to jitteriness, cyanosis, and poor feeding. Treatment involves increasing glucose infusion rates and encouraging breastfeeding.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    122 views23 pages

    Hypoglycemia in Neonates

    Uploaded by

    Nashirah Frinzz Hauzi
    Neonatal hypoglycemia occurs when a newborn's blood sugar level drops below 2.6 mmol/L. It can be caused by too much insulin, not enough glycogen stores, or insufficient glucose production or intake by the baby. Transient hypoglycemia may be due to conditions like sepsis or being born to a diabetic mother. Decreased glycogen stores can result from prematurity, growth restriction, or insufficient caloric intake. Recurrent or persistent hypoglycemia may be from hyperinsulinism, hormone deficiencies, or inherited metabolic disorders. Symptoms range from none to jitteriness, cyanosis, and poor feeding. Treatment involves increasing glucose infusion rates and encouraging breastfeeding.

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    Neonatal Hypoglycemia

    Definition
    • Blood Sugar level less than 2.6 mmol/L
    Glucose levels can drop if:

    • There is too much insulin in the blood


    (hyperinsulinism). Insulin is a hormone that pulls
    glucose from the blood into the cells to be used
    for energy.
    • There is not enough glycogen, the form in which
    glucose is stored in the body.
    • The baby is not producing enough glucose.
    • The baby’s body is using more glucose than is
    being produced.
    Hypoglycemia In Neonates
    • Transient Hypoglycemia
    • Decreased glycogen stores
    • Recurrent and persistant hypoglycemia
    Transient Hypoglycemia
    • Sepsis
    • Asphyxia
    • Hypothermia
    • Polycythemia
    • Infant of diabetic mother
    • Insufficient glucose administration
    • Shock
    • Maternal drug usage- exp: terbutaline,
    labetolol..
    • Exchange transfusion
    • Large for gestational age infants
    Decreased Glycogen Stores
    • Intrauterine growth restriction / small for
    gestational age
    • Premature / Postmature infants
    • Caloric intake is insufficient
    Recurrent and Persistant
    Hypoglycemia
    • Hormone excess hyperinsulinism
    • Hormone deficiencies
    • Hereditary defects in carbohydrate
    metabolism
    • Hereditary defects in amino acid
    metabolism
    Causes not to be missed
    • Expired dextrostrix
    • Patient kept NBM but no IVD/ IVD not up
    to requirement
    • IV line not functioning well
    Hypoglycemic babies may appear with
    symptoms or without symptoms
    Common symptoms of
    Hypoglycemia
    • Jitterness
    • Cyanosis
    • Apnea
    • Irregular respirations
    • Poor sucking or feeding
    • Tremors
    • Irritability
    • Hypotonia
    • Exaggerated moro reflex
    • Temperature instability
    Rarely,
    • Bradycardia / tachycardia
    • Abnormal cry (high pitched cry)
    • Tachypnea
    • Vomitting
    How causes and symptoms of
    hypoglycemia related
    • Infusion rate of glucose is 4-6mg/kg/min and can
    be increased up to 12-20mg/kg/min

    • Breast feeding should be encourage where


    possible

    • Milk Formula provides more energy/ml than


    D10%
    • Milk feed must not be discontinued or
    reduced when on IVD unless NEC is
    suspected

    • In premature babies/ babies that required


    fluid restriction, may increase
    concentration of glucose before volume
    increment.
    Investigations
    • DXT
    • FBC- to evaluate sepsis and to rule out
    polycythemia
    Follow-up studies for persistant
    Hypoglycemia
    Blood
    • Random Glucose
    • Lactate/ Pyruvate
    • Ketone Bodies
    • FFA
    • Aminoacids
    • Insulin/ C-peptide
    • Cortisol/growth
    • Hormone
    Urine
    • Ketones
    • Reducing substance
    • Organic acids
    Diagnostic Criteria For
    Hyperinsulinism
    • Glucose requirement >6-8mg/kg/min to maintain
    BS above 3mmol/L
    • Random BS<2.6mmol/L
    • Detectable insulin with raised C-peptide when
    hypoglycaemia
    • Low blood FFA and ketone body when
    hypoglycemia
    • Glycemis response after administration of
    glucagons when hypoglycaemia
    • Absence of ketouria.
    Complications of Hypoglycemia
    • Cardiac failure
    • Mental retardation
    • Cerebral Oedema
    • Renal failure

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