Hypoglycemia screening: Difference between revisions
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==Screening== | ==Screening== | ||
Screening of hypoglycemia should be obtained in these cases: | |||
* Whenever symptoms consistent with hypoglycemia occur. | |||
* Infants who are at risk for hypoglycemia: | |||
* First feed should occur within one hour after birth before 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> | |||
* Neonates with low blood glucose concentrations should be continuely 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.<ref name="pmid21357346">{{cite journal| author=Committee on Fetus and Newborn. Adamkin DH| title=Postnatal glucose homeostasis in late-preterm and term infants. | journal=Pediatrics | year= 2011 | volume= 127 | issue= 3 | pages= 575-9 | pmid=21357346 | doi=10.1542/peds.2010-3851 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21357346 }}</ref> | |||
* Treatment should be started immediately after primary blood test and we sholudn't wait the confirmatory laboratory results due to high risk of neurological outcome. | |||
* Glucose concentration measured in whole blood is 15% lower than that in plasma.<ref name="pmid25819173">{{cite journal| author=Stanley CA, Rozance PJ, Thornton PS, De Leon DD, Harris D, Haymond MW et al.| title=Re-evaluating "transitional neonatal hypoglycemia": mechanism and implications for management. | journal=J Pediatr | year= 2015 | volume= 166 | issue= 6 | pages= 1520-5.e1 | pmid=25819173 | doi=10.1016/j.jpeds.2015.02.045 | pmc=4659381 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25819173 }}</ref> | |||
* Continuous glucose monitoring using a sensor that measures interstitial glucose concentration was reported to be reliable. <ref name="pmid27203555">{{cite journal| author=Wackernagel D, Dube M, Blennow M, Tindberg Y| title=Continuous subcutaneous glucose monitoring is accurate in term and near-term infants at risk of hypoglycaemia. | journal=Acta Paediatr | year= 2016 | volume= 105 | issue= 8 | pages= 917-23 | pmid=27203555 | doi=10.1111/apa.13479 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27203555 }}</ref> | |||
==References== | ==References== | ||
Revision as of 13:39, 19 July 2017
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Risk calculators and risk factors for Hypoglycemia screening |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Screening
Screening of hypoglycemia should be obtained in these cases:
- Whenever symptoms consistent with hypoglycemia occur.
- Infants who are at risk for hypoglycemia:
- First feed should occur within one hour after birth before 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 continuely 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]
- Treatment should be started immediately after primary blood test and we sholudn't wait the confirmatory laboratory results due to high risk of neurological outcome.
- Glucose concentration measured in whole blood is 15% lower than that in plasma.[3]
- 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.