P. Fister
Klinični oddelek za neonatologijo, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana, Slovenija

T. Sluga
Zdravstveni dom Ljubljana, Ljubljana, Slovenija

Abstract

Hypoglycaemia is the most common metabolic disorder in newborns. After birth, transient mild decreases in blood glucose (BG) concentrations are physiological, therefore only neonates at risk of hypoglycaemia should be screened for low BG. The lowest acceptable BG concentration is difficult to define. The operational threshold most often used in clinical practice is at a BG concentration of 2.2 mmol/l in the first 24 hours of life and at 2.6 mmol/l after the first day of life. Clinical signs of hypoglycaemia in different neonates appear at different BG concentrations as the reaction of the sympathetic nervous system to hypoglycaemia and as a manifestation of the deprivation of BG in the brain. Persistent hypoglycaemia can be caused by: inadequate glucose supply, low glycogen stores, impaired glucose production and increased glucose utilisation with or without hyperinsulinism. Treatment depends on the neonate’s clinical condition. The first step is regular feeding with the proper amount of nutrients followed by oral or parenteral glucose substitution. Additional measures and medications are considered if necessary. After diagnosing hypoglycaemia in a neonate, BG should be measured regularly. Discharge from hospital is safe when a child is capable of maintaining BG within the normoglycaemic boundaries by regular oral feeds. Because of brain injuries caused by neonatal hypoglycaemia, regular follow-up of these patients is warranted.

Key words: Key words: hypoglycaemia, newborn, blood glucose, neurological manifestations.