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2 - Hypoglycaemia

Published online by Cambridge University Press:  15 February 2010

Amanda Ogilvy-Stuart
Affiliation:
University of Cambridge
Paula Midgley
Affiliation:
University of Edinburgh
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Summary

Clinical presentation

Hypoglycaemia may be picked up incidentally in an asymptomatic baby.

Blood glucose should be measured regularly in vulnerable babies (see below).

Symptoms are non-specific:

  • Neuroglycopaenic symptoms of hypoglycaemia include apnoea, hypotonia, jittering, irritability, lethargy, abnormal cry, feeding problems, convulsions, and coma.

  • Autonomic symptoms (pallor, sweating, tachypnoea) are generally not prominent in the newborn.

  • Macrosomia may be present in infants of diabetic mothers.

  • Macrosomia in the absence of a history of maternal diabetes suggests hyperinsulinism.

  • Macrosomia with magroglossia, organomegaly, exomphalos, or ear lobe creases suggests Beckwith–Wiedemann syndrome (approximately 80% demonstrate genotypic abnormalities of the distal region of chromosome 11p).

  • Midline defects, micropenis, and jaundice suggest hypopituitarism (see Chapter 7).

  • Babies can have low blood glucose levels and be completely asymptomatic.

Approach to the problem

  • Asymptomatic healthy term babies of normal birth weight (9th to 91st centiles) do not require blood sugar measurements.

  • Symptomatic hypoglycaemia in a term baby is always pathological until proved otherwise.

Babies at risk of hypoglycaemia

  • Preterm or intrauterine growth retardation: lack of glycogen stores, immature enzymes involved in glucose homoeostasis, inappropriately high insulin levels.

  • History of birth depression: lack of glycogen stores due to utilization.

  • Infants of diabetic mothers, large-for-dates babies, babies with Beckwith–Wiedemann syndrome, babies with rhesus disease: excessive insulin secretion.

  • Polycythaemia: excessive metabolism of glucose by erythrocytes.

  • Congenital heart disease, sepsis, hypothermia: excessive glucose demands.

  • […]

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2006

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  • Hypoglycaemia
  • Amanda Ogilvy-Stuart, University of Cambridge, Paula Midgley, University of Edinburgh
  • Book: Practical Neonatal Endocrinology
  • Online publication: 15 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544736.003
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  • Hypoglycaemia
  • Amanda Ogilvy-Stuart, University of Cambridge, Paula Midgley, University of Edinburgh
  • Book: Practical Neonatal Endocrinology
  • Online publication: 15 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544736.003
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Hypoglycaemia
  • Amanda Ogilvy-Stuart, University of Cambridge, Paula Midgley, University of Edinburgh
  • Book: Practical Neonatal Endocrinology
  • Online publication: 15 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544736.003
Available formats
×