Hypoglycemia screening: Difference between revisions
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==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 primary blood test | 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 | * 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 | * [[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 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> | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 19:38, 15 November 2017
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Hypoglycemia Microchapters |
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Hypoglycemia screening On the Web |
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American Roentgen Ray Society Images of Hypoglycemia screening |
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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
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.