Neonatal hypoglycaemia: History, clinical picture, investigations, management and outcome

Abstract

The aim of this article is to present the problem of neonatal hypoglycaemia through clinical cases. Hypoglycaemia is the most common neonatal metabolic disturbance. It may be picked up incidentally in a neonate without clinical signs, or anticipated in a neonate at risk of hypoglycaemia. The lowest accepted blood glucose (BG) concentration is difficult to define, the one most often used in clinical practice it is a BG concentration of 2.2 mmol/L in the first 24 hours of life and of 2.6 mmol/L after the first day of life. After birth, transient mild decreases in BG levels are physiological. If hypoglycaemia persists, samples of blood and urine should be taken to diagnose the etiological factor causing it if the condition is not otherwise evident.

Conclusion: Since persistent or recurrent hypoglycaemia may cause permanent long-term neurological impairment, it is important to diagnose and treat it appropriately and in good time in order to maintain normoglycaemia and assure normovolemia in a neonate. Moreover, the etiological factors causing hypoglycaemia should be sought so the therapy is also cause-targeted.