Elsevier

The Journal of Pediatrics

Volume 161, Issue 5, November 2012, Pages 775-776
The Journal of Pediatrics

Editorial
Neonatal Hypoglycemia—Answers, but More Questions

https://doi.org/10.1016/j.jpeds.2012.06.034Get rights and content

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    Several concerns about the application of the AAP or PES guidelines have been expressed. These recommendations are not firmly based on evidence from controlled studies, and they have not been compared in clinical trials to determine if either, or both, reduces adverse neurodevelopmental outcomes.15,16 If nurseries follow the PES recommendation of a higher cutoff and longer observation period for hypoglycemia, significant increases in neonatal intensive care unit (NICU) admissions and length of hospital stay may occur.17

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    Healthy newborn infants have higher plasma insulin concentrations than older children, despite lower glucose concentrations.28,29 It is possible that suppression of insulin secretion and establishment of regulation at a higher glucose concentration is gradual process, and the time required for this contributes to the lower plasma glucose concentrations in the first 48 hours after birth.30 After 72 hours, the mean plasma glucose concentrations continued to gradually increase to reach normal adult ranges, suggesting that this metabolic transition is completed by this time.

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  • Neonatal hypoglycemia

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    Are there advantages to having a lower blood glucose concentration compared with adults for the first two days of life? A decrease in glucose concentration soon after birth might be essential to stimulate physiological processes that are required for postnatal survival, including promoting glucose production through gluconeogenesis and glycogenolysis [11]. In addition, the decrease in glucose concentration enhances oxidative fat metabolism, stimulates appetite, and may help adapt to fast-feed cycles [11].

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P.R. is supported by NIH grants R01DK088139 and K08HD060688. The authors declare no conflicts of interest.

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