11: Glucose

Question 1

When should initial glucose testing be performed?

Answer 1

Within 30-60 minutes of birth. Perform on capillary whole blood.

Question 2

What is an abnormal screening for glucose?

Answer 2

<45

Question 3

What are risk factors for glucose testing?

Answer 3

1. Asphyxia, cold stress, increased work of breathing, possible sepsis (hypoglycemia secondary to increased metabolic response with increased use of glucose).
2. Mothers who have been administered excess intrapartum glucose or those receiving drug therapy including terbutaline, ritodrine, propranolol, and oral hypoglycemic agents.
3. Premature and postmature infants, infants with evidence of IUGR, or discordant twins.
4. Infants with diabetic mothers or large-for-gestational age infants (hyperinsulinemia resulting in rapid removal of glucose from the circulation).
5. Any infant with symptoms that could be secondary to hypoglycemia (i.e., jitteriness, hypothermia, apnea, tremor, hypotonia, cyanotic spells).