NEONATAL HYPOGLYCEMIA

Question 1

What is neonatal hypoglycemia

Answer 1

Random blood glucose below 2.6mmol/L in a newborn

Question 2

Clinical signs of hypoglycemia is absent in these group og neonates

Answer 2

Small infants
Sick infants
Infants of diabetic mothers

Question 3

Causes of neonatal hypoglycemia

Answer 3

Prematurity
Intrauterine growth restriction
Baby born to a diabetic mother
Infection
Asphyxia

Question 4

Symptoms of neonatal hypoglycemia

Answer 4

Irritability and restlessness
Tremors
Sweating
Seizures
Lethargy

Question 5

Signs of neonatal hypoglycaemia

Answer 5

Sweating
Tremor
Tachycardia
Seizures
Unconsciousness

Question 6

Investigations in neonatal hypoglycaemia

Answer 6

Random plasma glucose
Other invesigations depend on undeylying cause

Question 7

How often is blood glucose monitored in neonates at risk of hypoglycaemia

Answer 7

Check within 2hours after birth and at regular 3hours intervals for the first 24 hours until it stays above 3.5mmol/l for a further 24 hours

Question 8

Treatment objectives in neonatal hypoglycaemia

Answer 8

To maintain blood glucose levels within normal limits
To identify and treat underlying cause of hypoglycaemia
To prevent complications e.g. brain damage

Question 9

How often is blood glucose monitoring done in hypoglycaemic infants

Answer 9

Blood glucose monitoring ½ to 2 hourly in hypoglycaemic infants until normal levels attained

Question 10

Initial management of neonatal hypoglycaemia

Answer 10

Dextrose 10%, IV, 4 ml/kg as a bolus

Question 11

Maintenace treatment of neonatal hypoglycaemia

Answer 11

Saline 0.18% in Dextrose 10%, 60-150 ml/kg/day depending on the age of the newborn

Day Premature Term
1 60 ml/kg/day 50 ml/kg/day
2 90 ml/kg/day 70 ml/kg/day
3 110 ml/kg/day 90 ml/kg/day
4 130 ml/kg/day 120 ml/kg/day
≥ 5 150 ml/kg/day 120 ml/kg/day