Hypoglycemia

Question 1

plasma glucose falls in term babies to what value? And when does this happen?

Answer 1

2.2 mmol/l then it regulates to about 4 mmol/l

2 hours then 4 to 6 hours

Question 2

What does untreated hypoglycemia lead to?

Answer 2

Neurological and development sequelae

Question 3

Define hypoglycemia

severe hypoglycemia

Answer 3

<2,6mmol/l

<1,5mmol/l

Question 4

Causes of hypoglycemia:

Answer 4

Inadequate glucose supply:

• inadequate intake
• inadequate glycogen stores
• impaired glucose production

Increased glucose utilization:

• hyperinsulinism: IDM, Beckwith-Wiedemann Syndrome, IUGR,polycythemia
• without hyperinsulinism: sepsis, cardiac failure, perinatal hypoxia, respiratory distress, hypothermia

Question 5

Patients at risk:

Answer 5

• IDM
• IUGR
• Prematurity
• Small for GA
• LGA
• Perinatal or postnatalal stress

Question 6

What are the clinical signs?

Answer 6

Neurogenic signs:
- jitteriness, irritability, tachypnea, sweating, pallor

Neuroglycopenic:
- changes in level of consciousness, hypotonia, poor feeding or sucking, high pitched cry, seizures

Question 7

Management of hypoglycemia

Answer 7

• give milk feeds or start iv fluids if cx
• keep baby warm
• increase feeds until blood glucose is corrected
• if not, consider emergency

Question 8

What can severe hypoglycemia cause

Answer 8

neuronal cell death and reduced neurodevelopment

Question 9

Define severe hypoglycemia

Answer 9

bg <1,5mmol/l who is symptomatic and having seizures

Question 10

How to treat:

Answer 10

give bolus of 3ml/kg 10% glucose