Hypoglycaemia Flashcards
Low BM on NICU
<2.6mmols
Red hat babies
Pre term
Small for gestational age
Maternal diabetes
Maternal use of beta blockers
Insulin resistance in mother
Results in more sugar being diverted to placenta
Insulin secretion rises in fetus -> glycogen and fat storage
Babies with increased glucose demand
IUGR
PREMATURE
- insufficient glycogen and fat stores
- inability to generate new glucose
Signs of hypoglycaemia
- Lethargy
- high pitch cry
- Altered level of consciousness
- Hypotonia
- Hypothermia
- Cyanosis
- Apnoea
- Jitteriness
Management of hypoglycaemia
- Avoid cold stress - babytherm
- offer enteral feeds - NGT
- IV 10% dex
- Glucogel
Further management of hypoglycaemia
How often to check BM
Management if BM remains low
- Give 10% dex bolus
- Monitor BM’s hourly initially
- If BM’s remain low increase infusion rate and/or glucose percentage (>12.5% via central line)
Babies at risk of hyperinsulinism
- Diabetic mothers
- poorly controlled gestational diabetes
-Insulin resistance in mother causes increased insulin levels in baby resulting in hypoglycaemia
Dangers of hyperinsulinism
- Risk of brain damage due to hypoglycaemia
- Excess insulin causes glucose to disappear in blood stream very quickly
- Enteral feeding can stimulate insulin production and can exaggerate hypoglycaemia in some cases
- BM >3.5mmols
Hyperglycaemia causes & management BM >13mmols
- Stress -> asphyxia, surgery, sepsis
- Excess glucose/fluids/TPN
- Early onset diabetes
-reduce glucose intake
Babies with increased glucose demand
Prem
IUGR
- insufficient glycogen and fat store
- inability to generate new glucose
Glucose metabolism
Glucose for body to function -> cells burn glucose to produce energy
Insulin released in response to high sugar levels
