Incidence of Neonatal Hypoglycemia in Babies Identified as at Risk

Harris, Deborah L; Weston, Philip J.; Harding, Jane E.

doi:10.1016/j.jpeds.2012.05.022

Cited by 394 publications

(315 citation statements)

References 26 publications

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“…Oral carbohydrate is first-line treatment for low blood glucose concentrations in the conscious diabetic child or adult, 16 and sublingual glucose has been shown to be as effective as intravenous glucose for the treatment of hypoglycemic children with malaria. 17 21 on samples obtained by heel lances at one hour after birth, then three to four hourly before feeds for the first 24 hours, then six to eight hourly for the subsequent 24 hours. All blood glucose concentrations were measured using the glucose oxidase method (Radiometer, ABL800Flex, Copenhagen, Denmark, reading range 0·0 to 60 mmol/L, coefficient of variation 2·1%).…”

Section: Resultsmentioning

confidence: 99%

Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial

et al. 2013

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BackgroundNeonatal hypoglycemia is common and a preventable cause of brain damage.Dextrose gel is used to reverse hypoglycemia in diabetics. However, there is little evidence for its use in babies. MethodWe enrolled 514 babies 35 to 42 weeks' gestation, < 48 hours, and at risk of hypoglycemia, to a randomized, double-blind placebo controlled trial to determine whether 40% dextrose gel massaged into the buccal mucosa is more effective than feeding alone in reversing hypoglycemia. Hypoglycemic babies were randomized to 40% dextrose gel 200 mg/kg (n= 118) or placebo (n= 119) and encouraged to feed.Primary outcome was treatment failure (blood glucose concentration <2·6 mmol/L) after two treatment attempts. FindingsDextrose gel reduced the frequency of treatment failure (16/118 (14%) in dextrose vs. 29/119 (24%) in placebo group, RR 0·57; 95% CI 0·33 to 0·98; p=0·04). Babies receiving dextrose gel were less likely to be admitted to intensive care for hypoglycemia, (16/118 (14%) vs. 30/119 (25%); RR 0.54 (0.31, 0.93); P=0.03), to receive formula feeds (median 7 vs. 10 feeds; median difference 2; 95% CI 0 to 4; p=0·04) and to be formula fed at two weeks (5/118 (4%) vs.15/119 (13%), RR 0·34; 95% CI 0·13 to 0·90; p=0·03). 3 InterpretationDextrose gel should be considered for first-line treatment for management of hypoglycemia in late preterm and term babies in the first 48 hours after birth.

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Section: Resultsmentioning

confidence: 99%

Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial

et al. 2013

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“…9,10 The earliest marker for predicting hypoglycemia in first few hours of life would be cord blood sugar. 5 The maximum risk for hypoglycemia is in first 24 hours and definitely not after 72 hours except, in persistent hypoglycemia due to rare causes like inborn errors of metabolism and hyperinsulinism.…”

Section: Discussionmentioning

confidence: 99%

The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

Thirumalaikumarasamy

Ramalingam

Moorthi

et al. 2017

Int J Contemp Pediatr

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Background: Neonatal hypoglycemia is a common metabolic problem especially in cases like prematurity, sepsis and small gestational age. Episodes of asymptomatic hypoglycemia may occur due to many risk factors. The present study aimed to evaluate the incidence of asymptomatic hypoglycemia in term new born babies weighing more than 2 kg, to study the plasma sugar level at various time points during first 48 hours of life and to study the effect of maternal factors like parity, mode of delivery, glucose infusion during labour, and time since last feed on plasma sugar level.Methods: A hospital based longitudinal study was conducted over a period of one year from April 2005 to March 2006 in Kilpauk Medical College Hospital, Chennai. 400 babies born of consecutive deliveries were included in the study. Their plasma glucose levels were assessed in cord blood, 3 hr, 12 hr and 36 hr of life. Plasma glucose levels were analysed with regards to distribution, variables like parity, mode of delivery, dextrose infusion during labour and time since last feed. The plasma glucose levels were statistically analysed by paired student ‘t’ test, multiple analysis of variance (ANOVA), chi- square test using SPSS (version 7.5) statistical package.Results: The overall incidence of hypoglycemia was seen in 20% of the neonate’s in which 29.7% in small gestational age (SGA) and 16.7% in appropriate gestational age (AGA) babies. A significant (p <0.01) association between hypoglycemia and birth weight was observed. The association between hypoglycemia with parity, mode of delivery, sex of the baby and glucose infusion received by the mother was studied, but no significant association was found. A significant difference in plasma glucose based on birth weight at 3rd hour, 12th hour and 36th hour was observed (p <0.05). None of the infants showed any clinical signs of hypoglycemia.Conclusions: The incidence of hypoglycemia was noted in 20% of the neonates. Low birth weight was considered as risk factor. A significant association was also observed between plasma glucose, mode of delivery and time since last fed.

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“…Neonatal hipoglisemi, literatürde tam bir görüş birliği olmamakla birlikte, kan glukoz değerinin 47 mg/dL'nin altında olmasıdır (5) . Yenidoğan hipoglisemileri geçici (prematürite, intrauterin gelişme geriliği, diyabetik anne bebeği, sepsis, perinatal asfiksi, maternal toksemi, ilaç kullanımı gibi) veya kalıcı özellikte olabilir.…”

Section: Discussionunclassified

A Neonatal Case of Congenital Hyperinsulinism Due to Homozygous KCNJ11 Gene Mutation

Demirol¹,

Olukman²,

Elmas³

et al. 2017

Terh

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ÖZKonjenital hiperinsülinizm (KHİ), yenidoğan ve erken infantil dönemde yineleyici veya inatçı ağır hipogliseminin en sık nedenlerinden birisidir. Hastalığın görülme sıklığı toplumlar arasında farklılık göstermekle birlikte, genel populasyondaki sporadik oranlar yaklaşık 40000-50000 canlı doğumda birdir. Araplar, Ashkenazi Yahudileri ve Türkler gibi akraba evliliklerinin yaygın olduğu toplumlarda hastalığın ailesel formlarının görülme oranı 2500 canlı doğumda bire kadar yükselebilir. Etiyolojide sıklıkla pankreatik beta hücrelerinden insülin salınımında rol alan yolaklardaki genetik bozukluklar sorumlu tutulmaktadır. Ancak bugüne dek tanımlanabilen mutasyonların oranı hemen hemen %50 düzeyindedir. KHİ'de en yaygın rastlanan genetik defekt, K+ATP kanallarını oluşturan SUR1 ve Kir. 6,2'yi kodlayan, 11. kromozomda lokalize ABCC8 ve KCNJ11 gen mutasyonlarıdır. Bu makalede homozigot KCNJ11 gen mutasyonuna bağlı KHİ tanısı konulan bir yenidoğan olgusu, hastalığın inatçı ağır neonatal hipogliseminin ayırıcı tanısında önemini vurgulamak ve yüklü aile öyküsü varlığında ileri genetik çalışmaların gerekliliğine dikkat çekmek amacıyla sunulmuş-tur.Anahtar kelimeler: Konjenital hiperinsülinizm, KCNJ11 gen mutasyonu, olgu sunumu ABSTRACT Congenital hyperinsulinism (CHI) is one of the most common causes of recurrent or persistent severe hypoglycemia in the neonatal period and early infancy. Although the incidence may vary widely among different populations, the sporadic rates in the general population is approximately 1/40,000-50,000 live births. The incidence of the familial forms may be as high as 1/2,500 in certain communities like Arabs, Ashkenazi Jews and Turks, in which consanguineous marriages are common. Genetic disorders of the pathways of insulin release from pancreatic beta cells are frequently held responsible for the etiology. However the incidence rate of the identified mutations up to date is nearly 50 percent. The most common genetic defects found in CHI are mutations in the ABCCS and KCNJ11 genes, which are located on chromosome 11p and encode for the SUR1 and Kir 6.2 subunits of the KATP channels. Here we report a newborn infant diagnosed as CHI due to homozygous KCNJ11 gene mutation with the aim of emphasizing the importance of CHI in the differential diagnosis of persistent neonatal hypoglycemia and attracting attention to the necessity of further genetic studies in the presence of strong familial history.

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Incidence of Neonatal Hypoglycemia in Babies Identified as at Risk

Cited by 394 publications

References 26 publications

Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial

Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial

The incidence of asymptomatic hypoglycemia in term newborn babies weighing more than two kilograms

A Neonatal Case of Congenital Hyperinsulinism Due to Homozygous KCNJ11 Gene Mutation

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