Hypoglycemia screening: Difference between revisions
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==Screening== | ==Screening== | ||
Screening of hypoglycemia should be obtained in infants who are at risk for hypoglycemia: | Screening of hypoglycemia should be obtained in infants who are at risk for hypoglycemia: | ||
* First feed should occur within one hour after birth before the screening. | * First feed should occur within one hour after birth even before the [[screening]]. | ||
* Surveillance should be continued every three to six hours for the first 24 to 48 hours of life.<ref name="pmid22727868">{{cite journal| author=Harris DL, Weston PJ, Harding JE| title=Incidence of neonatal hypoglycemia in babies identified as at risk. | journal=J Pediatr | year= 2012 | volume= 161 | issue= 5 | pages= 787-91 | pmid=22727868 | doi=10.1016/j.jpeds.2012.05.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22727868 }}</ref> | * Surveillance should be continued every three to six hours for the first 24 to 48 hours of life.<ref name="pmid22727868">{{cite journal| author=Harris DL, Weston PJ, Harding JE| title=Incidence of neonatal hypoglycemia in babies identified as at risk. | journal=J Pediatr | year= 2012 | volume= 161 | issue= 5 | pages= 787-91 | pmid=22727868 | doi=10.1016/j.jpeds.2012.05.022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22727868 }}</ref> | ||
* Neonates with low blood glucose concentrations should be continually monitored until concentrations can be maintained with regular feedings in a normal range: >50 mg/dL. | * Neonates with low [[blood glucose]] concentrations should be continually monitored until concentrations can be maintained with regular feedings in a normal range: >50 mg/dL. | ||
* Hypoglycemia disorder should be considered if an infant is unable to maintain [[glucose]] concentrations >60 mg/dL after 48 hours of age. | * Hypoglycemia disorder should be considered if an infant is unable to maintain [[glucose]] concentrations >60 mg/dL after 48 hours of age. | ||
Revision as of 18:54, 18 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Screening of hypoglycemia should be obtained in infants who are at risk for hypoglycemia. Surveillance should be continued every three to six hours for the first 48 hours of life. Treatment should be started immediately after primary blood test and we should not wait for the confirmatory laboratory results due to high risk of the neurological outcome.
Screening
Screening of hypoglycemia should be obtained in infants who are at risk for hypoglycemia:
- First feed should occur within one hour after birth even before the screening.
- Surveillance should be continued every three to six hours for the first 24 to 48 hours of life.[1]
- Neonates with low blood glucose concentrations should be continually monitored until concentrations can be maintained with regular feedings in a normal range: >50 mg/dL.
- Hypoglycemia disorder should be considered if an infant is unable to maintain glucose concentrations >60 mg/dL after 48 hours of age.
- Plasma glucose concentration in an infant with a low glucose value determined by a glucose meter should be confirmed by laboratory measurement.[2]Glucose concentration measured in whole blood is 15% lower than that in plasma.[3]
- Treatment should be started immediately after primary blood test and we should not wait for the confirmatory laboratory results due to high risk of the neurological outcome.
- Continuous glucose monitoring using a sensor that measures interstitial glucose concentration was reported to be reliable.[4]
References
- ↑ Harris DL, Weston PJ, Harding JE (2012). "Incidence of neonatal hypoglycemia in babies identified as at risk". J Pediatr. 161 (5): 787–91. doi:10.1016/j.jpeds.2012.05.022. PMID 22727868.
- ↑ Committee on Fetus and Newborn. Adamkin DH (2011). "Postnatal glucose homeostasis in late-preterm and term infants". Pediatrics. 127 (3): 575–9. doi:10.1542/peds.2010-3851. PMID 21357346.
- ↑ Stanley CA, Rozance PJ, Thornton PS, De Leon DD, Harris D, Haymond MW; et al. (2015). "Re-evaluating "transitional neonatal hypoglycemia": mechanism and implications for management". J Pediatr. 166 (6): 1520–5.e1. doi:10.1016/j.jpeds.2015.02.045. PMC 4659381. PMID 25819173.
- ↑ Wackernagel D, Dube M, Blennow M, Tindberg Y (2016). "Continuous subcutaneous glucose monitoring is accurate in term and near-term infants at risk of hypoglycaemia". Acta Paediatr. 105 (8): 917–23. doi:10.1111/apa.13479. PMID 27203555.