Neonatal Hypoglycaemia Flashcards
How does insulin regulate blood sugar?
- Released by beta cells of pancreas
- Promotes glycogen formation and increases cell uptake of glucose
- Decreases blood sugar
How does glucagon regulate blood sugar?
- Released by alpha cells of pancreas
- Promotes break down of glycogen to glucose and production of glucose by liver
- Increases blood sugar
What is an abnormal neonatal BM?
<2 mmol/l
When should blood sugars not be checked?
Within first 2 hours of birth as they naturally drop at this time (they use stored fats for energy to start with)
What are the general symptoms of a hypoglycaemic baby?
- Abnormal cry
- Poor feeding
- Hypothermia
What are the cardio-respiratory symptoms of a hypoglycaemic baby?
- Tachypnoea
- Apnoea
- Cyanosis
What are the neurological symptoms of a hypoglycaemic baby?
- Jitters
- Irritability
- Lethargy
- Hypotonia
- Seizures
What is the difference between convulsions and jitters?
If the limbs are held, convulsions will continue but jittering will stop
Why are premature babies at increased risk?
- Low glycogen stores
- Available stores rapidly depleted
- Immature regulatory response
Why are SGA babies at increased risk?
- Low glycogen stores
- Polycythaemia
- Stress
Why are babies of diabetic mothers at increased risk?
- Glucose crosses placenta but insulin does not
- Infant produces more insulin in response to high sugar levels
- At birth, glucose supply is removed but insulin levels stay high
What is polycythaemia?
High percentage of RBC
How is hypoglycaemia treated?
- Maintain temperature
- Frequent feeding
- Glucose gel/ IV glucose
When can glucose gel be administered?
> 35/40 and <48 hours old
What is the procedure for administering glucose gel?
- 40% glucose, small amount on fingertip
- Apply to buccal membranes (gums)
- Follow with feed
- Recheck BM in 30-60 mins
- Max 6 doses in 48 hrs
