[64] Neonatal Hypoglycaemia Flashcards
What is hypoglycaemia defined as in neonates?
Plasma glucose of less than 2.6mmol/L
Is hypoglycaemia common in babies?
It is a common problem in neonates during the first few days of life, but thereafter is uncommon without diabetes
Why are infants at a higher risk of hypoglycaemia?
- High energy requirements
- Relatively poor reserves of glucose from gluconeogenesis and glycogenolysis
What is the result of infants being at high risk of hypoglycaemia with fasting?
Infants should never be starved for more than 4 hours, e.g. pre-operatively
What are the causes of neonatal hypoglycaemia?
- Hyperinsulinism
- Limited glycogen stores
- Increased glucose use
- Decreased gluconeogenesis
- Depleted glycogen stores
What is the most common cause of neonatal hypoglycaemia?
Hyperinsulinism
What is neonatal hypoglycaemia caused by hyperinsulinism also known as?
Persistent hyperinsulinaemia hypoglycaemia of infancy
When is hyperinsulinism very commonly seen?
In infants born to mothers with diabetes
When does neonatal hypoglycaemia caused by limited glycogen stores occur?
- Premature newborns
- Newborns that have IUGR
What can cause increased glucose use in a neonate?
- Hyperthermia
- Polycythaemia
- Sepsis
- Growth hormone deficiency
What can cause decreased gluconeogenesis in a neonate?
- Inborn errors of metabolism
- Adrenal insufficiency
What can cause depleted glycogen stores in a neonate?
- Starvation
- Asphyxia-perinatal stress
What are the categories of risk factors for neonatal hypoglycaemia?
- Maternal
- Neonatal
What are the maternal risk factors for neonatal hypoglycaemia?
- Gestational diabetes
- Eclampsia
- Drug use
What are the neonatal risk factors for neonatal hypoglycaemia?
- Small for gestational age
- Inadequate feeding
- Respiratory distress