Neonatal hypoglycemia - Revision history

Danbot: Add peer-reviewed reference

2026-03-22T10:16:05Z

Add peer-reviewed reference

← Older revision		Revision as of 10:16, 22 March 2026
Line 1:		Line 1:
	''This page is for <u>neonatal</u> hypoglycemia. See [[hypoglycemia]] for adult patients or [[non-neonatal hypoglycemia (peds)]].''		''This page is for <u>neonatal</u> hypoglycemia. See [[hypoglycemia]] for adult patients or [[non-neonatal hypoglycemia (peds)]].''
	==Background==		==Background==
	*3 births per 1000 with hypoglycemia		*3 births per 1000 with hypoglycemia<ref>Adamkin DH. Neonatal hypoglycemia. Semin Fetal Neonatal Med. 2017;22(1):36-43. PMID 27605513</ref>

	===Risks===		===Risks===

Danbot: Add MedicationDose entries for dextrose, glucagon

2026-03-20T21:14:14Z

Add MedicationDose entries for dextrose, glucagon

@@ Line 105: / Line 105: @@
 *Admit
 **Weaning IV dextrose infusion: When blood glucose has been stable for 12-24 h, begin decreasing IV infusion by 1-2 mL/hr q3-4 hours if blood glucose remains >60mg/dL.
 ==See Also==

ClaireLewis: /* References */

2019-10-06T18:37:20Z

References

← Older revision		Revision as of 18:37, 6 October 2019
Line 115:		Line 115:
	[[Category:Pediatrics]]		[[Category:Pediatrics]]
	[[Category:Endocrinology]]		[[Category:Endocrinology]]
			[[Category:FEN]]

ClaireLewis at 16:41, 28 September 2019

2019-09-28T16:41:35Z

← Older revision		Revision as of 16:41, 28 September 2019
Line 12:		Line 12:
	==Clinical Features==		==Clinical Features==
	*Jitteriness and irritability		*Jitteriness and irritability
	*Apnea and cyanosis		*[[shortness of breath (peds)\|Apnea and cyanosis]]
	*Hypotonia		*Hypotonia
	*Convulsions		*[[Seizure (peds)\|Convulsions]]

	==Differential Diagnosis==		==Differential Diagnosis==
Line 25:		Line 25:
	**Prolonged fasting without IV glucose		**Prolonged fasting without IV glucose
	*Hyperinsulinemia:		*Hyperinsulinemia:
	**Infant of diabetic mother		**Infant of [[DM\|diabetic mother]]
	**Islet cell hyperplasia		**Islet cell hyperplasia
	**Erythroblastosis fetalis		**Erythroblastosis fetalis
	**Exchange transfusion		**[[Exchange transfusion]]
	**Beckwith-Wiedemann Syndrome		**Beckwith-Wiedemann Syndrome
	**Maternal beta-mimetic tocolytic agents		**Maternal beta-mimetic [[tocolysis\|tocolytic agents]]
	**?High? umbilical arterial catheter		**?High? umbilical arterial catheter
	**Abrupt cessation of IV glucose		**Abrupt cessation of IV [[dextrose\|glucose]]
	*Other endocrine abnormalities:		*Other endocrine abnormalities:
	**Pan-hypopituitarism		**Pan-hypopituitarism
Line 39:		Line 39:
	*Increased glucose utilization:		*Increased glucose utilization:
	**Cold stress/[[hypothermia]]		**Cold stress/[[hypothermia]]
	**Increased work of breathing		**Increased [[shortness of breath (peds)\|work of breathing]]
	**[[Sepsis]]		**[[Sepsis]]
	**Perinatal asphyxia		**Perinatal asphyxia
	*Miscellaneous conditions:		*Miscellaneous conditions:
	**Polycythemia		**[[Polycythemia]]
	**[[Congenital heart disease]]		**[[Congenital heart disease]]
	**CNS abnormalities		**CNS abnormalities
Line 51:		Line 51:
	**Idiopathic, asphyxia, rhesus diagnoses, Beckwith-Weiderman, Nesiodoblastosis (autosomal recessive hyperinsulinism)		**Idiopathic, asphyxia, rhesus diagnoses, Beckwith-Weiderman, Nesiodoblastosis (autosomal recessive hyperinsulinism)
	*Not enough anti-insulin:		*Not enough anti-insulin:
	**Hypopituitarism, adrenal hyperplasia		**Hypopituitarism, [[CAH\|adrenal hyperplasia]]
	*[[Inborn errors of metabolism]]		*[[Inborn errors of metabolism]]
	**Glycogen storage disease, fatty oxidation errors		**Glycogen storage disease, fatty oxidation errors
Line 60:		Line 60:

	''There is a normal fall in glucose @ 2-4hr of life''		''There is a normal fall in glucose @ 2-4hr of life''

			*If no obvious precipitant, consider workup for [[inborn errors of metabolism]]

	==Management==		==Management==

Rossdonaldson1: /* General Treatment */

2019-08-16T00:31:58Z

General Treatment

← Older revision		Revision as of 00:31, 16 August 2019
Line 87:		Line 87:
	**While awaiting consult, send blood (while blood sugar is low) for glucose, plasma cortisol, growth hormone and insulin concentrations		**While awaiting consult, send blood (while blood sugar is low) for glucose, plasma cortisol, growth hormone and insulin concentrations
	**Further management may include [[glucocorticoids]], [[diazoxide]], somatostatin or pancreatectomy.		**Further management may include [[glucocorticoids]], [[diazoxide]], somatostatin or pancreatectomy.


	===Calculate rate of glucose administration===		===Calculate rate of glucose administration===

Rossdonaldson1 at 00:31, 16 August 2019

2019-08-16T00:31:29Z

← Older revision		Revision as of 00:31, 16 August 2019
Line 87:		Line 87:
	**While awaiting consult, send blood (while blood sugar is low) for glucose, plasma cortisol, growth hormone and insulin concentrations		**While awaiting consult, send blood (while blood sugar is low) for glucose, plasma cortisol, growth hormone and insulin concentrations
	**Further management may include [[glucocorticoids]], [[diazoxide]], somatostatin or pancreatectomy.		**Further management may include [[glucocorticoids]], [[diazoxide]], somatostatin or pancreatectomy.
	*Weaning IV dextrose infusion: When blood glucose has been stable for 12-24 h, begin decreasing IV infusion by 1-2 mL/hr q3-4 hours if blood glucose remains >60mg/dL.

	===Calculate rate of glucose administration===		===Calculate rate of glucose administration===
Line 103:		Line 103:
	==Disposition==		==Disposition==
	*Admit		*Admit
			**Weaning IV dextrose infusion: When blood glucose has been stable for 12-24 h, begin decreasing IV infusion by 1-2 mL/hr q3-4 hours if blood glucose remains >60mg/dL.

	==See Also==		==See Also==

Rossdonaldson1: /* Disposition */

2019-08-16T00:29:52Z

Disposition

← Older revision		Revision as of 00:29, 16 August 2019
Line 102:		Line 102:

	==Disposition==		==Disposition==
			*Admit

	==See Also==		==See Also==

Rossdonaldson1: /* General Treatment */

2019-08-16T00:28:14Z

General Treatment

← Older revision		Revision as of 00:28, 16 August 2019
Line 87:		Line 87:
	**While awaiting consult, send blood (while blood sugar is low) for glucose, plasma cortisol, growth hormone and insulin concentrations		**While awaiting consult, send blood (while blood sugar is low) for glucose, plasma cortisol, growth hormone and insulin concentrations
	**Further management may include [[glucocorticoids]], [[diazoxide]], somatostatin or pancreatectomy.		**Further management may include [[glucocorticoids]], [[diazoxide]], somatostatin or pancreatectomy.
	*Weaning IV dextrose infusion: When blood glucose has been stable for 12-24 h, begin decreasing IV infusion by 1-2 mL/hr q3-4 hours if blood glucose remains ~~�60mg~~/dL.		*Weaning IV dextrose infusion: When blood glucose has been stable for 12-24 h, begin decreasing IV infusion by 1-2 mL/hr q3-4 hours if blood glucose remains >60mg/dL.

	===Calculate rate of glucose administration===		===Calculate rate of glucose administration===

Rossdonaldson1: /* Differential DIagnosis */

2019-08-16T00:26:33Z

Differential DIagnosis

← Older revision		Revision as of 00:26, 16 August 2019
Line 16:		Line 16:
	*Convulsions		*Convulsions

	==Differential ~~DIagnosis~~==		==Differential Diagnosis==
			===Neonatal hypoglycemia===
	*Decreased substrate availability		*Decreased substrate availability
	**Intra-uterine growth retardation		**Intra-uterine growth retardation
Line 46:		Line 47:
	**CNS abnormalities		**CNS abnormalities

	===Persistent===		===Persistent neonatal hypoglycemia===
	*Too much insulin:		*Too much insulin:
	**~~idiopathic~~, asphyxia, rhesus diagnoses, Beckwith-Weiderman, Nesiodoblastosis (autosomal recessive hyperinsulinism)		**Idiopathic, asphyxia, rhesus diagnoses, Beckwith-Weiderman, Nesiodoblastosis (autosomal recessive hyperinsulinism)
	*Not enough anti-insulin:		*Not enough anti-insulin:
	**~~hypopituitarism~~, adrenal hyperplasia		**Hypopituitarism, adrenal hyperplasia
	*[[Inborn errors of metabolism]]		*[[Inborn errors of metabolism]]
	**~~glycogen~~ storage disease, fatty oxidation errors		**Glycogen storage disease, fatty oxidation errors

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Differential DIagnosis */

2019-08-16T00:25:42Z

Differential DIagnosis

← Older revision		Revision as of 00:25, 16 August 2019
Line 29:		Line 29:
	**Exchange transfusion		**Exchange transfusion
	**Beckwith-Wiedemann Syndrome		**Beckwith-Wiedemann Syndrome
	**Maternal �-mimetic tocolytic agents		**Maternal beta-mimetic tocolytic agents
	**?High? umbilical arterial catheter		**?High? umbilical arterial catheter
	**Abrupt cessation of IV glucose		**Abrupt cessation of IV glucose