Update on neonatal hypoglycemia

Curr Opin Endocrinol Diabetes Obes. 2014 Feb;21(1):45-50. doi: 10.1097/MED.0000000000000027.

Abstract

Purpose of review: Neonatal hypoglycemia is one of the most common biochemical abnormalities encountered in the newborn. However, controversy remains surrounding its definition and management especially in asymptomatic patients.

Recent findings: New information has been published that describes the incidence and timing of low glucose concentrations in the groups most at risk for asymptomatic neonatal hypoglycemia. Furthermore, one large prospective study failed to find an association between repetitive low glucose concentrations and poor neurodevelopmental outcomes in preterm infants. But hypoglycemia due to hyperinsulinism, especially genetic causes, continued to be associated with brain injury. New advances were made in the diagnosis and management of hyperinsulinism, including acquired hyperinsulinism in small for gestational age infants and others. Continuous glucose monitoring remains an attractive strategy for future research in this area.

Summary: The fundamental question of how best to manage asymptomatic newborns with low glucose concentrations remains unanswered. Balancing the risks of overtreating newborns with low glucose concentrations who are undergoing a normal transition following birth against the risks of undertreating those in whom low glucose concentrations are pathological, dangerous, and/or a harbinger of serious metabolic disease remains a challenge.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Biosensing Techniques
  • Blood Glucose / metabolism*
  • Developmental Disabilities / prevention & control
  • Diazoxide / therapeutic use
  • Diuretics / therapeutic use
  • Female
  • Glucose / metabolism*
  • Humans
  • Hydrochlorothiazide / therapeutic use
  • Hyperinsulinism / diagnosis*
  • Hyperinsulinism / drug therapy
  • Hyperinsulinism / metabolism
  • Hypoglycemia / diagnosis*
  • Hypoglycemia / drug therapy
  • Hypoglycemia / metabolism
  • Infant, Newborn
  • Infant, Premature
  • Male
  • Monitoring, Physiologic*
  • Potassium Chloride / therapeutic use
  • Vasodilator Agents / therapeutic use

Substances

  • Blood Glucose
  • Diuretics
  • Vasodilator Agents
  • Hydrochlorothiazide
  • Potassium Chloride
  • Glucose
  • Diazoxide