Exploring the long-term impacts of neonatal hypoglycemia to determine a safe threshold for glucose concentrations

European Journal of Pediatrics, Journal Year: 2025, Volume and Issue: 184(4)

Published: March 22, 2025

Abstract Hypoglycemia and impaired metabolic transition are frequently observed in neonates during the first 24–48 h after birth [1, 2]. Severe (< 36 mg/dL or 2 mmol/L) recurrent (3 more episodes) hypoglycemia can cause neurological injury developmental delays. The ambiguity regarding a threshold blood glucose concentration remains due to differing values proposed by various professional organizations. This poses challenge diagnosing neonatal addition using single value, which itself is not entirely reflective of key molecular processes uncovered vitro pre-clinical studies. symptoms also be present conditions other than hypoglycemia, e.g., sepsis polycythemia, many cases, clinically unrecognized. Therefore, early screening at-risk otherwise healthy-appearing essential. Continuous monitoring interventions such as gel, breast formula feeding, intravenous administration utilized prevent long-term impairments. However, safe limits serum that will neuroglycopenia neural elusive. impact available therapies on neurodevelopmental outcomes uncertain absence robust clinical design combining all causes without making further distinctions from conditions. review highlights controversies definitions most recent information may management NH. Conclusion : Optimizing treatment dysglycemia crucial for preventing hypoglycemia-related brain injury. technology offers promising approach real-time intervention. What Known: • There ongoing debate optimal intervention prevention hypoglycemia-induced suggests incurred over range rather concentration. New: Recent studies suggest concentrations between (2 47 (2.6 acceptable asymptomatic neonates. was school age with <36 mg/dl (<2 mid-childhood <30-36 (<1.7 -2 mmol/L). (CGM) measurement glycemic lability Its use mitigate neurologic improving recognition treatment.

Language: Английский

Persistent hypoglycemia in congenital syphilis: hyperinsulinemic hypoglycemia with a focal pancreatic lesion

Journal of Pediatric Endocrinology and Metabolism, Journal Year: 2024, Volume and Issue: 38(1), P. 79 - 81

Published: Nov. 27, 2024

Abstract Objectives Congenital syphilis can cause severe morbidities such as hydrops fetalis, preterm birth, low birth weight, hepatosplenomegaly, pneumonia, hypoglycemia, etc., and mortality. Despite hypoglycemia being reported in congenital hyperinsulinism, only one case was described. In this article, we aimed to present a newborn with born syphilitic mother who diagnosed persistent hyperinsulinemic focal lesion during follow-up. Case presentation A female patient weight of 2,450 g the 32 +3rd week pregnancy from 30-year-old had pleural effusion ascites, cholestasis, thrombocytopenia, anemia at birth. Hypoglycemia detected on 10th day patient’s follow-up (47 mg/dL). The unresponsive diazoxide, octreotide, nifedipine, glucagon treatments were started gradually. No variants HH gene panel, but pancreatic head fluorine-18 L-3,4 dihydroxyphenylalanine positron emission tomography-computed tomography. Focal lesionectomy recommended for patient. Conclusions neonate early lesions diazoxide. Although be seen has been before, associated hyperinsulinism is very rare; few patients have presented, not previously reported. pathology unknown, pancreatitis may entity.

Language: Английский