Abstract
Hypoglycemia is a medical emergency in the newborn nursery. The requirements for glucose homeostasis, definition of hypoglycemia, classification of hypoglycemia (increased glucose utilization versus decreased glucose production), diagnostic evaluation and management will be presented. Clinical cases will be used to illustrate important disorders.
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Cornblath M, Schwartz R.Disorders of Carbohydrate Metabolism in Infancy. Philadelphia: WB Saunders Company, 1976.
Srinivasan G, Pildes RS, Cattamanachi G Voora S, Lillien LD. Plasma glucose values in normal neonates: a new look.J Pediatr 1986; 109: 114–117.
Heck LJ, Erenberg A. Serum glucose levels in term neonates during the first 48 hours of life.J Pediatr 1987; 110: 119–122.
Holtrop PC, Madison KA, Kiechle FL, Karcher RE, Batton DG. A comparison of chromogen test strip (chemstrip bG) and serum glucose values in newborns.Am J Dis Child 1990; 144: 183–185.
Conrad PD, Sparks JW, Osberg I, Abrams L, Hay WW. Clinical application of a new glucose analyzer in the neonatal intensive care unit: comparison with other methods.J Pediatr 1989; 114: 281–287.
Kappy MS. Carbohydrate metabolism and hypoglycemia. In: Kappy MS, Blizzard RM, Migeon CJ, eds.The Diagnosis and Treatment of Endocrine Disorders in Childhood and Adolescents, Springfield: Charles C. Thomas, 1994; 919–959.
Geffner ME. Hypoglycemia. In: Kaplan SA, ed.Clinical Pediatric Endocrinology, Philadelphia: WB Saunders Company, 1990: 165–179.
Pagliara AS, Karl IE, Haymond M, Kipnis DM. Hypoglycemia in infancy and childhood.J Pediatr 1973; 82: 365–379.
Senior B, Sadeghi-Nejad A. Hypoglycemia: a pathophysiologic approach.Acta Pediatr Scand 1989; Suppl 352: 1–27.
Baker L, Stanley CL. Neonatal hypoglycemia. In: Bardin CW, ed.Current Therapy in Endocrinology and Metabolism, St. Louis; Mosby; 1994: 376–380.
Stanley CA, Anday EK, Baker L, Delivoria-Papadopolous M. Metabolic fuel and hormone responses in newborn infants.Pediatrics 1979; 64: 613–619.
Allen DB. Postprandial hypoglycemia resulting from nasogastric tube malposition.Pediatrics 1988; 81: 582–583.
Procianoy RS, Pinheiro CE. Neonatal hyperinsulinism after short-term maternal beta sympathomimetic therapy.J Pediatr 1982; 101: 612–614.
Jaffe R, Hashida Y, Yunis EJ. Pancreatic pathology in hyperinsulinemic hypoglycemia of infancy.Lab Invest 1980; 42: 356–365.
Rahier J, Falt K, Muntefering Het al. The basic structural lesion of persistent neonatal hypoglycemia with hyperinsulinism.Diabetologia 1984; 26: 282–289.
Worden FP, Freidenberg G, Pescovitz OH. The diagnosis and management of neonatal hyperinsulinism.The Endocrinologist 1994; 4: 196–204.
Stanley CA, Baker L. Hyperinsulinism in infancy: diagnosis by demonstration of abnormal response to fasting hypoglycemia.Pediatrics 1976; 57: 702–711.
Thornton PS, Sumner AE, Ruchelli EDet al. Familial and sporadic hyperinsulinism: histopathologic findings and segregation analysis support a single autosomal recessive disorder.J Pediatr 1991; 119: 721–724.
Mayefsky JH, Sarnaik AP, Postellon DC. Factitious hypoglycemia.Pediatrics 1982; 69: 804–805.
Gastineau CF. Is reactive hypoglycemia a clinical entity?Mayo Clin Proc 1983; 58: 545–549.
Hogan MJ, Service FJ, Sharbrough FW, Gerich JE. Oral glucose tolerance test compared with a mixed meal in the diagnosis of reactive hypoglycemia.Mayo Clin Proc 1983; 58: 491–496.
Berlin I, Grimaldi A, Landault C, Cesselin F, Puech AJ. Suspected postprandial hypoglycemia is associated with B-adrenergic hypersensitivity and emotional distress.J Clin Endocrinol Metab 1994; 79: 1428–1433.
Bougneres PF, Saudubray JM, Marsac Cet al. Fasting hypoglycemia resulting from hepatic carnitine palmitoyl transferase deficiency.J Pediatr 1981; 98: 742–746.
Roe CR, Millington DS, Maltby MSet al. Recognition of medium-chain Acyl-CoA dehydrogenase deficiency in asymptomatic siblings of children dying of sudden infant death or reye-like syndromes.J Pediatr 1986; 108: 13–18.
Chen YT, Coleman RA, Scheinman JIet al. Renal disease in type I glycogen storage disease.New Engl J Med 1988; 318: 7–11.
Howell RR, Stevenson RE, Ben-Menachem Yet al. Hepatic adenomata with type I glycogen storage disease.JAMA 1976; 236: 1481–1484.
Schwenk WF, Haymond MW. Optimal rate of enteral glucose administration in children with glycogen storage disease type I.N Engl J Med 1986; 314: 682–685.
Chen YT, Cornblath M, Sidbury JB. Cornstarch therapy in type I glycogen storage disease.N Engl J Med 1984; 310: 171–174.
Wolfsdorf JI, Keller RJ, Landy H, Crigler J. Glucose therapy for glycogenosis type I in infants: comparison of intemittent uncooked cornstarch and continuous over-night glucose feedings.J Pediatr 1990; 117: 384–391.
Melancon SB, Khachadurain AK, Nadler HL, Brown BI. Metabolic and biochemical studies in fructose 1,6 diphosphatase deficiency.J Pediatr 1973; 82: 650–657.
Odievre M, Gentil C, Gautier M, Alagille D. Hereditary fructose intolerance in childhood.Am J Dis Child 1978; 132: 605–608.
Pagliara AS, Karal TE, De Vivo DCet al. Hypoalaninemia; a concomitant of ketotic hypoglycemia.J Clin Invest 1972; 51: 1440–1449.
Roe TF, Kogut MD. Hypopituitarism and ketotic hypoglycemia.Am J Dis Child 1971; 121: 296–299.
Lovinger RD, Kaplan SL, Grumbach MM. Congenital hypopituitarism associated with neonatal hypoglycemia and microphallus.J Pediatr 1975; 87: 1171–1181.
Hopwood NJ, Forsman PJ, Kenny FM, Drash AL. Hypoglycemia in hypopituitary children.Am J Dis Child 1975; 129: 918–929.
Cryer PE. Hypoglycemia awareness in IDDM.Diabetes Care 1993; 16: 40–46.
White NJ, Warrell DA, Chanthavanich Pet al. Severe hypoglycemia and hyperinsulinemia in falciparum malaria.N Eng J Med 1983; 309: 61–66.
Finegold DN, Stanley CA, Baker L. Glycemic response to glucagon during fasting hypoglycemia: an aid in the diagnosis of hyperinsulinism.J Pediatr 1980; 96: 257–259.
Wiener D, Smith J, Dahlem Set al. Serum adrenal steroid levels in healthy full-term 3 day old infants.J Pediatr 1987; 110: 122–124.
Saudubray JM, Marsac C, Limal JMet al. Variations in plasma ketone bodies during a 24 hour fast in normal children and children with ketotic hypoglycemia.J Pediatr 1981; 98: 904–908.
Chaussain JL. Glycemic response to 24 hour fast in normal children and children with ketotic hypoglycemia.J Pediatr 1973; 82: 438–443.
Thornton PS, Alter CA, Levitt Katz LEet al. Short and long term use of octreotide in the treatment of congenital hyperinsulinism.J Pediatr 1993; 123: 637–643.
Koivisto M, Blanco-Sequeiros M, Krause U. Neonatal symptomatic and asymptomatic hypoglycemia: a follow-up study of 151 children.Develop Med Child Neurol 1972; 14: 603–614.
Baker L, Stanley CA. Management of hyperinsulinism in infants.J Pediatr 1991; 119: 755–757.
Thomas CG, Cuenca RE, Azizkhan RG, Underwood LE, Carney CN. Changing concepts of islet cell displasia in neonatal and infantile hyperinsulin.World J Surg 1988; 12: 598–609.
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Schwartz, R.P. Hypoglycemia in infancy and childhood. Indian J Pediatr 64, 43–55 (1997). https://doi.org/10.1007/BF02795776
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DOI: https://doi.org/10.1007/BF02795776