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Hypoglycemia is the most common metabolic problem in newborns. [2] Neonatal hypoglycemia is hypothesized to occur in between 1 in 3 births out of every 1,000 births, but the true number is not known since there is no international standard for measurement. It often occurs in premature and small babies and babies of diabetic mothers.
During the 48-hour neonatal period, the neonate adjusts glucagon and epinephrine levels following birth, which may cause temporary hypoglycemia. [8] As a result, there has been difficulty in developing guidelines on interpretation and treatment of low blood glucose in neonates aged less than 48 hours. [ 8 ]
Neonatal diabetes is a genetic disease, caused by genetic variations that were either spontaneously acquired or inherited from one's parents. At least 30 distinct genetic variants can result in neonatal diabetes. [8] The development and treatment of neonatal diabetes will vary based on the particular genetic cause.
The mainstay of physiologic ketotic hypoglycemia treatment typically includes management of the underlying cause, fluid resuscitation, and dietary supplementation of sugars and carbohydrates. [2] Alanine is a direct precursor in gluconeogenesis and can be used for treatment of ketotic hypoglycemia.
Usually this hypoglycemia can easily be treated with more frequent feedings or medical doses of glucose. Rarely (<5%) children with BWS will continue to have hypoglycemia after the neonatal period and require more intensive treatment. [5] Such children may require tube feedings, oral hyperglycemic medicines, or a partial pancreatectomy.
Recurrent mild hypoglycemia may fit a reactive hypoglycemia pattern, but this is also the peak age for idiopathic postprandial syndrome, and recurrent "spells" in this age group can be traced to orthostatic hypotension or hyperventilation as often as demonstrable hypoglycemia. [citation needed] Insulin-induced hypoglycemia