Hypoglycaemia

Question 1

Is hypoglycaemia normal in a new born?

Answer 1

Yes- in the first 24 hours

Question 2

What is the classification for neonatal hypoglycaemia?

Answer 2

< 2.6 mmol/L

Question 3

What can persistent/severe hypoglycaemia may be caused by:

Answer 3

• preterm birth (< 37 weeks)
• maternal diabetes mellitus
• IUGR
• hypothermia
• neonatal sepsis
• inborn errors of metabolism
• nesidioblastosis
• Beckwith-Wiedemann syndrome

Question 4

Which syndrome can result in persistent/severe hypoglycaemia?

Answer 4

• Beckwith-Wiedemann syndrome

Question 5

How can hypoglycaemia present?

Answer 5

Asymptomatically

Question 6

What are the classifications of features that hypoglycaemia can present with?

Answer 6

autonomic (hypoglycaemia → changes in neural sympathetic discharge)
neuroglycopenic

Question 7

What autonomic features can hypoglycaemia present with?

Answer 7

• ‘jitteriness’
• irritable
• tachypnoea
• pallor

Question 8

What neuroglycopenic features can hypoglycaemia present with?

Answer 8

• poor feeding/sucking
• weak cry
• drowsy
• hypotonia
• seizures

Question 9

What is the management of hypoglycaemia dependent on?

Answer 9

The severity of the hypoglycaemia and if the newborn is symptomatic

Question 10

What is the management of an asymptomatic new born?

Answer 10

• encourage normal feeding (breast or bottle)

* monitor blood glucose

Question 11

What is the management of symptomatic hypoglycaemia?

Answer 11

• admit to the neonatal unit

* intravenous infusion of 10% dextrose