Hypoglycemia screening: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
Line 4: Line 4:


==Overview==
==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 a primary [[blood test]] and we should not wait for the confirmatory laboratory results due to high risk of the [[Neurological disease|neurological]] outcome.
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 a primary [[blood test]].
==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 even 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 of >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.


* [[Plasma glucose]] concentration in an infant with a low [[glucose]] value determined by a [[glucose]] meter should be confirmed by laboratory measurement. [[Glucose]] concentration measured in whole blood is 15% lower than that in [[Blood plasma|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><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>
* [[Plasma glucose]] concentration in an infant with a low [[glucose]] value determined by a finger stick [[glucose]] measure should be confirmed by laboratory measurement. [[Glucose]] concentration measured in whole blood is 15% lower than that in [[Blood plasma|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><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 should not wait for the confirmatory laboratory results due to high risk of the [[Neurological disorders|neurological]] outcome.
* 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 disorders|neurological]] outcome.
* 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>
* 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>

Latest revision as of 19:38, 15 November 2017

Hypoglycemia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypoglycemia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypoglycemia screening On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypoglycemia screening

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypoglycemia screening

CDC on Hypoglycemia screening

Hypoglycemia screening in the news

Blogs on Hypoglycemia screening

Directions to Hospitals Treating Hypoglycemia

Risk calculators and risk factors for Hypoglycemia screening

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 a primary blood test.

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 of >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 finger stick glucose measure should be confirmed by laboratory measurement. Glucose concentration measured in whole blood is 15% lower than that in plasma.[2][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

  1. 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.
  2. 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.
  3. 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.
  4. 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.