Transient Neonatal Hypoglycemia - Long-Term Effects on Neurodevelopmental Outcome

Dalgıç, Nazan; Ergenekon, Ebru; Soysal, Şebnem; Koç, Esin; Atalay, Yıldız; Gücüyener, Kıvılcım

doi:10.1515/jpem.2002.15.3.319

Cited by 31 publications

(19 citation statements)

References 7 publications

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“…2.6 mmol/l) are associated with a considerable increase in adverse neurodevelopmental sequelae stressing the importance of minimizing the number of any hypoglycemic events. Similarly, other studies have demonstrated an increased risk of persistent neurodevelopmental delays, reduced head circumference, reduced IQ scores and an increased rate of clinical complications at the time of birth associated with a delay in diagnosis and adequate management of hypoglycemia in the neonate [7][8][9][10] . Studies of infants with HI also indicate an increased incidence of neurodevelopmental problems associated with a delay in the recognition and management of hypoglycemia [1,[11][12][13][14][15] .…”

Section: Discussionmentioning

confidence: 79%

“…The benefi ts of timely diagnosis and treatment of neonatal hypoglycemia of unspecifi ed etiology have been studied. As one might expect, the incidence of neurologic sequelae is higher in infants suffering symptomatic versus asymptomatic hypoglycemic episodes [7,8] . Lucas et al [9] demonstrated that multiple episodes of moderate hypoglycemia ( !…”

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

Prenatal Diagnosis and Postnatal Management of Diffuse Congenital Hyperinsulinism: A Case Report

Peranteau

Ganguly²,

Steinmuller³

et al. 2006

Fetal Diagn Ther

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We present the first case of the prenatal diagnosis of congenital hyperinsulinism based on the genetic analysis of known family mutations in the SUR1 gene. An amniocentesis was performed at 16 weeks gestation at which time two mutations in the SUR1 gene were identified consistent with the diagnosis of diffuse hyperinsulinism. The mother was transported to our facility and underwent an elective cesarian section at 38 weeks gestation. The diagnosis was confirmed and treatment was initiated within the first minutes of life. After a short course of failed medical management, the patient underwent a 98% pancreatectomy with subsequent good glycemic control. This case highlights the benefits of the timely in utero diagnosis of hyperinsulinism by mutational analysis.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 93%

Prenatal Diagnosis and Postnatal Management of Diffuse Congenital Hyperinsulinism: A Case Report

Peranteau

Ganguly²,

Steinmuller³

et al. 2006

Fetal Diagn Ther

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show abstract

“…11,12 Increases in neurodevelopmental abnormalities have been found in infants who have hypoglycemia associated with abnormal clinical signs, especially those with severe, persistent hyperinsulinemic hypoglycemia. [11][12][13][14][15][16] Rozance and Hay 17 have delineated the conditions that should be present before considering that long-term neurologic impairment might be related to neonatal hypoglycemia. Transient, single, brief periods of hypoglycemia are unlikely to cause permanent neurologic damage.…”

Section: Physiologymentioning

confidence: 99%

“…1,21 Because severe, prolonged hypoglycemia with clinical signs may result in neurologic injury, 11,14,15,58 Initiation and establishment of breastfeeding, and reduction of hypoglycemia risk, are facilitated by skinto-skin contact between the mother and her infant immediately after birth for at least the first hour of life and continuing as much as possible. Such practices will maintain normal infant body temperature and reduce energy expenditure (thus enabling maintenance of normal blood glucose) while stimulating suckling and milk production.…”

Section: Clinical Manifestations Of Hypoglycemiamentioning

confidence: 99%

ABM Clinical Protocol #1: Guidelines for Blood Glucose Monitoring and Treatment of Hypoglycemia in Term and Late-Preterm Neonates, Revised 2014

Wight¹,

Marinelli²

2014

Breastfeeding Medicine

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A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.Purpose

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“…do em prematuros e pequenos para a idade gestacional (PIG), em filhos de mães diabéticas, em crianças com hiperinsulinismo, pacientes com sepse, hipotermia, anó-xia perinatal e cardiopatia congênita (4,5). Aproximadamente 50% desses episódios hipoglicêmicos são assintomáticos e detectados devido a algum fator predisponente associado (6).…”

Section: Ticiana C Rodrigues Maikel Colli Mauro a Czepielewskiunclassified

Hipoglicemia na infância: resultados de um protocolo de avaliação prospectiva em crianças com até 1 ano de idade

Rodrigues

Colli

Czepielewski

2007

Arq Bras Endocrinol Metab

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RESUMOO objetivo deste trabalho é relatar a experiência na aplicação de um protocolo de avaliação de hipoglicemia. Realizamos um estudo prospectivo com treze crianças com sintomas de hipoglicemia atendidas no Hospital de Clínicas de Porto Alegre, com idade média de 5,3 ± 4,5 meses, das quais oito pacientes eram do sexo feminino. Os pacientes foram submetidos ao teste de jejum, estímulo com glucagon e dosagens de glicemia, lactato, pH, ácidos graxos, insulina, peptídeo C, TSH, GH e cortisol, além de urina para avaliação de cetonúria. Dos treze pacientes avaliados, oito apresentaram hipoglicemia persistente e cinco apresentaram hipoglicemia transitória. O diagnóstico mais freqüente foi hiperinsulinismo persistente. Sugerimos a utilização de um protocolo simples de avaliação para hipoglicemia, que contempla as principais etiologias em crianças e que facilita o manejo desses pacientes. The aim of this study is to present the experience of applying hypoglycemia evaluation protocol. We performed a prospective study with 13 children with hypoglycemia symptoms at the Hospital of Clinicas of Porto Alegre, with range age 5.3 ± 4.5 months and eight patients are female. The patients had been submitted to glucagon fasting test and blood glucose, lactate, pH, C peptide, insulin, fatty acids, TSH, GH, cortisol, and urine ketones were measured. Eight patients presented persistent hypoglycemia and five presented transitory hypoglycemia. The most frequent diagnosis was persistent hyperinsulinism. We suggest the use of a simple protocol for the evaluation of hypoglycemia, which contemplates the identifications of the main etiologies in children and facilitates the handling of these patients. (Arq Bras Endocrinol Metab 2007;51/9:1493-1497) Keywords: Hypoglycemia; Childhood; Neonates; Children A HIPOGLICEMIA É UM ACHADO FREQÜENTE em recém-nascidos (RN), particularmente no primeiro ano de vida (1). Na maioria dos RN saudáveis, a freqüente observação dos níveis reduzidos de glicemia não está relacionada a qualquer problema clínico e reflete um processo normal de adaptação à vida extra-uterina (2). Aproximadamente 30% dos RN não conseguem manter seus níveis de glicemia maiores que 30 mg/dl, caso sua primeira refeição seja atrasada em 3 a 6 horas após o seu nascimento (3). A hipoglicemia é geralmente causada por redução das reservas de energia, hiperinsulinemia e/ou excessivo gasto energético. O risco de hipoglicemia transitória está aumenta-

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Transient Neonatal Hypoglycemia - Long-Term Effects on Neurodevelopmental Outcome

Abstract: Neonatal hypoglycemia is a dangerous condition for its acute and chronic complications, and may be observed in infants with no clear risk factors. However, if acted upon early, these complications are preventable with mostly very simple measures.

Cited by 31 publications

References 7 publications

Prenatal Diagnosis and Postnatal Management of Diffuse Congenital Hyperinsulinism: A Case Report

Prenatal Diagnosis and Postnatal Management of Diffuse Congenital Hyperinsulinism: A Case Report

ABM Clinical Protocol #1: Guidelines for Blood Glucose Monitoring and Treatment of Hypoglycemia in Term and Late-Preterm Neonates, Revised 2014

Hipoglicemia na infância: resultados de um protocolo de avaliação prospectiva em crianças com até 1 ano de idade

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