Neonatal hypoglycaemia: aetiologies.
Diagnosis of glucose status requires knowledge of the homeostatic mechanisms that maintain the blood glucose concentration between the narrow range of 2.5 and 7.5 mmol/l during periods of eating or fasting. Hypoglycaemia occurring within the first few hours after eating is suggestive of hyperinsulinism. Most glucose is subsequently converted into glycogen in the liver, and hypoglycaemia occurring during this phase is suggestive of glycogenosis. During fasting, gluconeogenesis progressively replaces glycogen as the major source of blood glucose, and hypoglycaemia occurring during this period is suggestive of impaired gluconeogenesis or fatty acid disorders. Growth hormone, glucagon, cortisol and insulin-like growth factor 1 deficiencies may also play a role. Other causes of hypoglycaemia have also been identified recently, namely glucose transporter disorders, respiratory chain disorders and congenital disorders of glycosylation.
de Lonlay
Pascale
P
Department of Paediatrics, Hôpital Necker -- Enfants Malades, 149 rue de Sèvres, 75743 Paris cedex 15, France. pascale.delonlay@nck.ap-hop-paris.fr
Giurgea
Irina
I
Touati
Guy
G
Saudubray
Jean-Marie
JM
D006801:Humans; D007003:Hypoglycemia / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology*; D007231:Infant, Newborn