Hypoglycaemia Flashcards
Hypoglycaemia is likely in first 24 hours in babies with…
IUGR Preterm Mother has DM Large for dates Hypothermic Polycythaemic Ill for any reason
Growth restricted and preterm babies have poor.. storage
Glycogen
Infants of diabetic mothers have good glycogen stores, but are prone to hypoglycaemia. Why is this?
Due to the increased transfer of glucose across the placenta, the beta cells in the pancreas of the fetus undergo hyperplasia and produce more insulin. The increased insulin pushes glucose into cells.
What symptoms are associated with hypoglycaemia in neonates?
Jitteriness Irritability Apnoea Lethargy Drowsiness Seizures
Is there an agreed definition of hypoglycaemia in newborns?
No
Many babies tolerate low blood glucose levels in first few days of life - they can use lactate as energy stores
Some studies suggest above 2.6 = desirable for optimal neurodevelopmental outcome
Can prolonged, symptomatic hypoglycaemia cause permanent neurological disability?
Yes
How can it be prevented?
Early and frequent milk feeding
When should glucose be given as an IV infusion?
If an asymptomatic infant has 2 low readings in spite of adequate feeding
Or one very low value e.g less than 1.6
Or becomes symptomatic
How should high concentration of IV infusions of glucose be given?
Via a central venous catheter to avoid extravasation into tissue - may cause skin necrosis
If there is difficulty or delay in starting infusion, what can be given?
Glucagon
