Neonatal hypoglycaemia in infants of diabetic mothers

Agrawal, Rahul; Lui, Kei; Gupta, J. M.

doi:10.1046/j.1440-1754.2000.00512.x

Cited by 66 publications

(48 citation statements)

References 17 publications

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“…The high incidence of hypoglycemia (as defined here) in the present study correlates with a previous report [9] , although in the current study a different cut-off point was used. Other authors who used lower cut-off points described lower rates of hypoglycemia in IDM infants [4,21] .…”

Section: Discussionsupporting

confidence: 89%

Hypoglycemia Rates in the First Days of Life among Term Infants Born to Diabetic Mothers

2009

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Objectives: To discover the risk factors for developing hypoglycemia in newborns born to diabetic mothers and to characterize the rates of glucose concentrations in the first two days of life. Methods: Retrospective recordings of medical charts of 576 healthy term infants of diabetic mothers during an 18-month period. We determined the following pre-feeding glucose concentrations: ‘normoglycemia’ (≥47 mg/dl = 2.6 mmol/l), ‘mild hypoglycemia’ (40–46 mg/dl = 2.2– 2.5 mmol/l), ‘moderate hypoglycemia’ (30–39 mg/dl = 1.7–2.1 mmol/l) and ‘severe hypoglycemia’ (<30 mg/dl = 1.7 mmol/l). Results: Glucose concentrations below ‘normoglycemia’ and ‘severe hypoglycemia’ were observed in 280 (48.6%) and 23 (4%) of the infants, respectively. The main risk factors for developing glucose concentrations below ‘normoglycemia’ in the first day of life were large size for gestational age and maternal insulin-dependent diabetes mellitus. ‘Severe hypoglycemia’ was more common among infants born to mothers who needed insulin (either type A2 or insulin-dependent diabetes mellitus). Infants born to mothers with insulin-dependent diabetes mellitus were less mature, heavier, large for their gestational age and exhibited more ‘severe and moderate hypoglycemia’ in the first day of life as compared to infants born to diabetes type A1 and A2 mothers. In addition, infants who were large for gestational age tended to have more ‘moderate hypoglycemia’ when born to diabetes type A1 mothers compared to small and appropriate-for-gestational-age infants. Thirty infants (5%) still had hypoglycemia on the second day of life. This subgroup of infants did not differ with regard to maternal-type diabetes. Conclusions: Infants born to diabetic mothers tend to have a high rate of hypoglycemia on the first day of life when a relatively high cut-off point (≥47 mg/dl = 2.6 mmol/l) is used. Infants born large for gestational age as well as those born to mothers with juvenile diabetes mellitus are at higher risk and should be closely monitored.

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Section: Discussionsupporting

confidence: 89%

Hypoglycemia Rates in the First Days of Life among Term Infants Born to Diabetic Mothers

2009

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“…No studies have demonstrated harm from a few hours of asymptomatic hypoglycemia during this normal postnatal period of establishing "physiologic glucose homeostasis." 9 Infants born to mothers with diabetes may develop asymptomatic NH as early as 1 hour after birth 18 and usually by 12 hours of age. 18 In contrast, infants who are large for gestational age or small for gestational age may develop low plasma glucose concentrations at as early as 3 hours of age, 19 and these infants may be at risk of NH for up to 10 days after birth.…”

Section: Figurementioning

confidence: 99%

“…9 Infants born to mothers with diabetes may develop asymptomatic NH as early as 1 hour after birth 18 and usually by 12 hours of age. 18 In contrast, infants who are large for gestational age or small for gestational age may develop low plasma glucose concentrations at as early as 3 hours of age, 19 and these infants may be at risk of NH for up to 10 days after birth. 20 Therefore, at-risk infants should be screened for NH with a frequency and duration related to risk factors specific to the individual infant.…”

Section: Figurementioning

confidence: 99%

Postnatal Glucose Homeostasis in Late-Preterm and Term Infants

Adamkin¹

2011

Pediatrics

602

278

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This report provides a practical guide and algorithm for the screening and subsequent management of neonatal hypoglycemia. Current evidence does not support a specific concentration of glucose that can discriminate normal from abnormal or can potentially result in acute or chronic irreversible neurologic damage. Early identification of the at-risk infant and institution of prophylactic measures to prevent neonatal hypoglycemia are recommended as a pragmatic approach despite the absence of a consistent definition of hypoglycemia in the literature.

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“…Previously maintained by a maternal-fetal flux of substrates, neonatal glucose levels fall during the first hour or two after birth, reaching a natural trough before rising to stable neonatal levels. The (27). Holtrop (22) found that the average times for finding low glucose levels in LGA and SGA infants were 2.9 h (range 0.8 h to 8.5 h) and 6.1 h (range 0.8 h to 34.2 h), respectively.…”

Section: When Should At-risk Infantsmentioning

confidence: 99%