title: An emerging evidence base for the management of neonatal hypoglycaemia.
abstract: Neonatal hypoglycaemia is common, and screening and treatment of babies considered at risk is widespread, despite there being little reliable evidence upon which to base management decisions. Although there is now evidence about which babies are at greatest risk, the threshold for diagnosis, best approach to treatment and later outcomes all remain uncertain. Recent studies suggest that treatment with dextrose gel is safe and effective and may help support breast feeding. Thresholds for intervention require a wide margin of safety in light of information that babies with glycaemic instability and with low glucose concentrations may be associated with a higher risk of later higher order cognitive and learning problems. Randomised trials are urgently needed to inform optimal thresholds for intervention and appropriate treatment strategies.
authors.affiliation: Liggins Institute, University of Auckland, 85 Park Ave, Grafton, Auckland 1023, New Zealand. Electronic address: j.harding@auckland.ac.nz.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Harding
authors.affiliation: Liggins Institute, University of Auckland, 85 Park Ave, Grafton, Auckland 1023, New Zealand; Waikato Hospital, Selwyn Street and Pembroke Street, Hamilton 3204, New Zealand. Electronic address: Deborah.Harris@waikatodhb.health.nz.
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Harris
authors.affiliation: Liggins Institute, University of Auckland, 85 Park Ave, Grafton, Auckland 1023, New Zealand; National Women's Health, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1023, New Zealand. Electronic address: jhegarty@adhb.govt.nz.
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Hegarty
authors.affiliation: Liggins Institute, University of Auckland, 85 Park Ave, Grafton, Auckland 1023, New Zealand; National Women's Health, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1023, New Zealand; Department of Paediatrics: Child and Youth Health, University of Auckland, 2 Park Rd, Grafton, Auckland 1023, New Zealand. Electronic address: j.alsweiler@auckland.ac.nz.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Alsweiler
authors.affiliation: Liggins Institute, University of Auckland, 85 Park Ave, Grafton, Auckland 1023, New Zealand; Department of Paediatrics: Child and Youth Health, University of Auckland, 2 Park Rd, Grafton, Auckland 1023, New Zealand; Kidz First Neonatal Care, Counties Manukau Health, Private Bag 93311, Otahuhu, Auckland, New Zealand. Electronic address: c.mckinlay@auckland.ac.nz.
authors.forename: Christopher Jd
authors.initials: CJ
authors.lastname: McKinlay
mesh_terms: D019468:Disease Management; D019317:Evidence-Based Medicine; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic
keywords: Breast feeding; Congenital hyperinsulinism; Hypoglycaemia; Infant of diabetic mother; Nneonatal; Preterm; Screening tests