Persistent neonatal hypoglycemia: Diagnosis and management.
Maintenance of plasma glucose depends on a normal endocrine system, functional enzyme levels for glycogenolysis, gluconeogenesis and other processes, and there must be an adequate supply of endogenous fat, glycogen and substrates of gluconeogenesis. Neonatal hypoglycemia should be defined as serum glucose less than 2.2 mmol/L in the first 72 h of life and less than 2.5 mmol/L thereafter. The purpose of this paper is to review the more uncommon causes of hypoglycemia in the full term, apparently healthy neonate. Most of these conditions are inborn errors of metabolism. A protocol for investigation of these conditions and some of the more common diseases, such as hyperinsulinism, is provided, with a rationale explaining why these tests may be helpful.
Marles
S L
SL
Section of Clinical Genetics and Metabolism and Section of Neonatology, Department of Paediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba.
Casiro
O G
OG
Pediatrics. 1976 May;57(5):702-11
940710
Biol Neonate. 1990;58 Suppl 1:16-21
2265215
Hum Genet. 1986 Oct;74(2):143-54
3770742
Arch Dis Child Fetal Neonatal Ed. 1994 Jan;70(1):F60-4; discussion F65
8117132
Arch Dis Child. 1992 Jan;67(1):142-5
1739332
Dev Neurosci. 1994;16(5-6):307-12
7768210
Lancet. 1991 Feb 2;337(8736):298-9
1671131
Endocrinol Metab Clin North Am. 1989 Mar;18(1):211-52
2645128
Eur J Pediatr. 1990 May;149(8):577-81
2347356
J Pediatr. 1992 Jul;121(1):1-11
1625065
J Inherit Metab Dis. 1995;18(4):473-90
7494405
Pediatrics. 1990 Apr;85(4):600-3
2314976
Pediatr Rev. 1989 Oct;11(4):117-24
2678050