Glucose Infusion Rate
NEONATAL HYPOGLYCEMIA
Hypoglycemia is a prevalent metabolic disturbance in neonates, particularly within the early postnatal period. It is commonly defined as a plasma glucose level <45 mg/dL (2.5 mmol/L) in the first 72 hours of life. After 72 hours, the glycemia should be ≥3.3 mmol/l. Routine glucose monitoring is recommended for at-risk infants to ensure prompt detection and management (glucose infusion rate, GIR).
Pathophysiology
Primarily involves an imbalance between glucose supply and demand, which can lead to significant neurological implications due to the brain’s reliance on glucose as a primary energy substrate.
Risk Factors
This condition is associated with a variety of perinatal risk factors, including maternal diabetes, prematurity, intrauterine growth restriction (IUGR), and being large for gestational age (LGA).
Clinical manifestations
jitteriness, hypotonia, apneic episodes, poor feeding, and, in severe cases, seizures, with risks of neurodevelopmental sequelae if left untreated.
Therapy
Enteral feeding with breast milk or formula, and intravenous dextrose administration may be required for persistent or severe cases. Treatment aims to maintain blood glucose levels >45 mg/dL (2.5 mmol/L) to reduce the risk of hypoglycemia-induced brain injury.
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