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Neonatal hypoglycemia

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https://www.readbyqxmd.com/read/28916591/continuous-glucose-monitoring-in-very-preterm-infants-a-randomized-controlled-trial
#1
Alfonso Galderisi, Andrea Facchinetti, Garry M Steil, Paulina Ortiz-Rubio, Francesco Cavallin, William V Tamborlane, Eugenio Baraldi, Claudio Cobelli, Daniele Trevisanuto
BACKGROUND AND OBJECTIVES: Impaired glucose control in very preterm infants is associated with increased morbidity, mortality, and poor neurologic outcome. Strategies based on insulin titration have been unsuccessful in achieving euglycemia in absence of an increase in hypoglycemia and mortality. We sought to assess whether glucose administration guided by continuous glucose monitoring (CGM) is more effective than standard of care blood glucose monitoring in maintaining euglycemia in very preterm infants...
September 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28901668/dilatation-of-the-ductus-arteriosus-by-diazoxide-in-fetal-and-neonatal-rats
#2
Katsuaki Toyoshima, Kazuo Momma, Tetsuko Ishii, Toshio Nakanishi
BACKGROUND: Diazoxide, an ATP-sensitive potassium channel opener, is the main therapeutic agent for treating hyperinsulinemic hypoglycemia. We aimed to determine the in vivo ductus-dilating effects of diazoxide in fetal and neonatal rats. METHODS: Near-term rat pups delivered via a cesarean section were housed at 33°C. After rapid whole-body freezing, The ductus arteriosus (DA) diameter was measured using a microscope and a micrometer. Full-term pregnant rats (gestational day 21) were intraperitoneally injected with diazoxide (10 and 100 mg/kg) 4 h before delivery, and the neonatal DA diameter was measured at 0, 30, or 60 min after birth...
September 13, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28892225/expectant-management-of-pregnancies-complicated-by-fetal-growth-restriction-without-any-evidence-of-placental-dysfunction-at-term-comparison-with-routine-labor-induction
#3
Nobuhiro Hidaka, Yuka Sato, Saki Kido, Yasuyuki Fujita, Kiyoko Kato
AIM: To assess the feasibility and practicality of expectant management for pregnancies with fetal growth restriction (FGR) at term without evidence of placental dysfunction. METHODS: We reviewed the records of pregnancies with an estimated fetal weight ≤ 1.5 SD below the mean at 37 weeks of gestation. We excluded elective cesarean deliveries and pregnancies that, at 37 weeks, were complicated by oligohydramnios, decreased fetal cerebroplacental ratio, or pregnancy-related hypertensive disorders...
September 11, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28867036/-biological-monitoring-and-other-explorations-in-the-acute-phase-of-a-neonatal-arterial-ischemic-stroke-excluding-hemostasis
#4
G Favrais, S Nguyen The Tich
Neonatal monitoring and other explorations required just after neonatal arterial ischemic stroke (NAIS) diagnosis remain elusive. This review attempts to propose guidelines on this topic. During neonatal period, three major contexts related to NAIS emerge: 1) Metabolic disorders including hypoglycemia; 2) Early post-natal infections; 3) Cardio-vascular anomalies. Different patient profiles have been defined (typical, atypical and at risk profiles). According to these profiles, a final decisional tree including biological monitoring and complementary explorations has been suggested to caregivers...
September 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28864965/pharmacological-management-of-gestational-diabetes-mellitus
#5
Geetha Mukerji, Denice S Feig
Gestational diabetes mellitus (GDM) is associated with an increased risk of adverse pregnancy outcomes in the setting of poor glycemic control. The initial management for GDM includes intensive lifestyle modification, which often requires behavioral and nutritional changes to optimize glycemic control. Pharmacotherapy for GDM is initiated when glycemic targets are not met. The rapid-acting bolus analogues aspart and lispro achieve postprandial targets with less hypoglycemia compared to regular insulin, with similar fetal outcomes...
September 2, 2017: Drugs
https://www.readbyqxmd.com/read/28857766/glucose-gel-as-a-treatment-strategy-for-transient-neonatal-hypoglycemia
#6
Katherine M Newnam, Marissa Bunch
BACKGROUND: Transient asymptomatic neonatal hypoglycemia (TANH) is common as infants transition from their mother's energy stores to their own. There is little evidence supporting the blood glucose threshold that indicates a need for treatment although sustained hypoglycemia has been correlated with negative neurodevelopmental consequences. Treatment of TANH includes a stepwise approach from supplemental enteral feedings, buccal glucose gel, intravenous dextrose infusion, and/or transfer to special care units including neonatal intensive care units...
August 29, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28854840/should-delivery-timing-for-repeat-cesarean-be-reconsidered-based-on-dating-criteria
#7
Kathleen F Brookfield, Sarah S Osmundson, Aaron B Caughey
PURPOSE: We sought to examine if the method of pregnancy dating at five increasing term gestational ages is associated with increasing neonatal morbidity. MATERIALS AND METHODS: A cohort of women who underwent elective repeat cesarean delivery at > 37 weeks' gestation were identified from the NICHD MFMU Network registry. We excluded women who were in labor, those carrying a fetus with a congenital anomaly, those with a nonreassuring fetal heart tracing, and those with preeclampsia, preexisting chronic hypertension or diabetes...
August 30, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28851713/scp4-promotes-gluconeogenesis-through-foxo1-3a-dephosphorylation
#8
Jin Cao, Yi Yu, Zhengmao Zhang, Xi Chen, Zhaoyong Hu, Qiang Tong, Jiang Chang, Xin-Hua Feng, Xia Lin
FoxO1 and FoxO3a (collectively FoxO1/3a) proteins regulate a wide array of cellular processes including hepatic gluconeogenesis. Phosphorylation of FoxO1/3a is a key event that determines its subcellular location and transcriptional activity. During glucose synthesis, the activity of FoxO1/3a is negatively regulated by Akt-mediated phosphorylation, which leads to the cytoplasmic retention of FoxO1/3a. However, the nuclear phosphatase that directly regulates FoxO1/3a remains to be identified. In this study, we discovered a nuclear phosphatase SCP4/CTDSPL2 that dephosphorylated FoxO1/3a and promoted FoxO1/3a transcription activity...
August 29, 2017: Diabetes
https://www.readbyqxmd.com/read/28837137/maternal-and-neonatal-demographics-of-macrosomic-infants-admitted-to-the-neonatal-intensive-care-unit
#9
J N Tolosa, D A Calhoun
OBJECTIVE: The objective of this study is to determine the incidence, significance, associated demographics and impact of macrosomic infants (⩾4 kg) admitted to the Neonatal Intensive Care Unit (NICU) on NICU census and resources. STUDY DESIGN: A retrospective cohort review was performed from 2010 to 2015. Descriptive statistical analyses were used. RESULTS: Of 19 308 deliveries, 1823 were infants ⩾4000 g and 213 were admitted to the NICU...
August 24, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28835142/a-retrospective-study-comparing-outcomes-in-a-midwestern-us-population-after-introduction-of-iadpsg-guidelines-for-gestational-diabetes
#10
Gene T Lee, Megha Teeka Satyan, Jill D Grothusen, Kelsi M Drummond, Grace Hagen, Crystal Brown, Catherine L Satterwhite
OBJECTIVE: More evidence is required to endorse the 1-step approach for gestational diabetes mellitus (GDM) for clinical practice. Since 2010, our department has pragmatically allowed faculty to selfselect the guidelines they use to screen and diagnose GDM. We sought to compare the maternal and neonatal outcomes from these two simultaneous cohorts. STUDY DESIGN: We performed a retrospective cohort study of all singleton pregnancies delivered between October 2011-November 2013 at our hospital...
August 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28819941/maternal-and-neonatal-outcomes-of-pregnancy-at-39-weeks-and-beyond-with-mild-gestational-diabetes-mellitus
#11
Hanqing Chen, Suhua Zou, Jianbo Yang, Songqing Deng, Jian Cai, Zilian Wang
OBJECTIVES: The purpose of this study was to retrospectively analyze maternal and neonatal outcomes in pregnant women with mild gestational diabetes mellitus at 39 weeks compared to 40 weeks. MATERIAL AND METHODS: Clinical data of 372 cases of mild gestational diabetes mellitus form First Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. There were 108 mild GDM patients that delivered at 40-40+6 weeks in our research group, and 264 patients that delivered in 39-39+6 weeks in the control group...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28817693/clinical-signs-profound-acidemia-hypoglycemia-and-hypernatremia-are-predictive-of-mortality-in-1-400-critically-ill-neonatal-calves-with-diarrhea
#12
Florian M Trefz, Ingrid Lorenz, Annette Lorch, Peter D Constable
Profound acidemia impairs cellular and organ function and consequently should be associated with an increased risk of mortality in critically ill humans and animals. Neonatal diarrhea in calves can result in potentially serious metabolic derangements including profound acidemia due to strong ion (metabolic) acidosis, hyper-D-lactatemia, hyper-L-lactatemia, azotemia, hypoglycemia, hyperkalemia and hyponatremia. The aim of this retrospective study was to assess the prognostic relevance of clinical and laboratory findings in 1,400 critically ill neonatal calves with diarrhea admitted to a veterinary teaching hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28804631/the-influence-of-d-chiro-inositol-and-d-myo-inositol-in-pregnant-women-with-glucose-intolerance
#13
Domenico Dell'Edera, Francesca Sarlo, Arianna Allegretti, Francesca Simone, Maria Giovanna Lupo, Annunziata Anna Epifania
The aim of the present study was to demonstrate that the use of inositol and folic acid from the first trimester of pregnancy, counteracts the onset of gestational diabetes mellitus (GDM) in women at risk, preserving the infants from macrosomia, hypoglycemia and preterm delivery. The authors collected data from the pregnant women at the laboratory (Unit of Cytogenic and Molecular Genetics), from January 2014 to April 2016, all with first trimester fasting plasma glucose (FPG) >92 mg/dl. A total of 40 women were treated with 250 mg/day D-chiro-inositol, 1...
August 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28797149/-investigation-of-pregestational-diabetes-mellitus-in-15-hospitals-in-guangdong-province
#14
H T Chen, S Q Deng, Z Y Li, Z L Wang, Q Li, J K Gao, Y H Zhong, D M Suo, L N Lu, S L Pan, H X Chen, Y Y Cui, J H Fan, J Y Wen, L R Zhong, F Z Han, Y H Wang, S J Hu, P P Liu
Objective: To investigate the morbidity, diagnostic profile and perinatal outcome of pregestational diabetes mellitus (PGDM) in 15 hospitals in Guangdong province. Methods: A total of 41 338 women delivered in the 15 hospitals during the 6 months, 195 women with PGDM (PGDM group) and 195 women with normal glucose test result (control group) were recruited from these tertiary hospitals in Guangdong province from January 2016 to June 2016. The morbidity and diagnostic profile of PGDM were analyzed. The complications during pregnancy and perinatal outcomes were compared between the two groups...
July 25, 2017: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28793129/clinical-characteristics-of-women-with-gestational-diabetes-comparison-of-two-cohorts-enrolled-20-years-apart-in-southern-brazil
#15
Angela Jacob Reichelt, Letícia Schwerz Weinert, Livia Silveira Mastella, Vanessa Gnielka, Maria Amélia Campos, Vânia Naomi Hirakata, Maria Lúcia Rocha Oppermann, Sandra Pinho Silveiro, Maria Inês Schmidt
CONTEXT AND OBJECTIVE: The prevalence and characteristics of gestational diabetes mellitus (GDM) have changed over time, reflecting the nutritional transition and changes in diagnostic criteria. We aimed to evaluate characteristics of women with GDM over a 20-year interval. DESIGN AND SETTING: Comparison of two pregnancy cohorts enrolled in different periods, in university hospitals in Porto Alegre, Brazil: 1991 to 1993 (n = 216); and 2009 to 2013 (n = 375). METHODS: We applied two diagnostic criteria to the cohorts: International Association of Diabetes and Pregnancy Study Groups (IADPSG)/World Health Organization (WHO); and National Institute for Health and Care Excellence (NICE)...
July 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28783802/association-of-neonatal-glycemia-with-neurodevelopmental-outcomes-at-4-5-years
#16
Christopher J D McKinlay, Jane M Alsweiler, Nicola S Anstice, Nataliia Burakevych, Arijit Chakraborty, J Geoffrey Chase, Gregory D Gamble, Deborah L Harris, Robert J Jacobs, Yannan Jiang, Nabin Paudel, Ryan J San Diego, Benjamin Thompson, Trecia A Wouldes, Jane E Harding
Importance: Hypoglycemia is common during neonatal transition and may cause permanent neurological impairment, but optimal intervention thresholds are unknown. Objective: To test the hypothesis that neurodevelopment at 4.5 years is related to the severity and frequency of neonatal hypoglycemia. Design, Setting, and Participants: The Children With Hypoglycemia and Their Later Development (CHYLD) Study is a prospective cohort investigation of moderate to late preterm and term infants born at risk of hypoglycemia...
August 7, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28782409/association-between-antenatal-corticosteroids-and-neonatal-hypoglycemia-in-indicated-early-preterm-births
#17
Spencer G Kuper, Sima H Baalbaki, Melissa M Parrish, Victoria C Jauk, Alan T Tita, Lorie M Harper
PURPOSE: We sought to determine if administration of antenatal corticosteroids in early preterm births (<34 weeks) is associated with an increased risk of developing neonatal hypoglycemia (<40 mg/dL) within the first 48 h of neonatal life. MATERIALS AND METHODS: Retrospective cohort of all indicated singleton preterm births (23-34 weeks) in a single tertiary center from 2011 to 2014. The primary outcome was neonatal hypoglycemia (<40 mg/dL) within the first 48 h of life...
August 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28771572/comparison-of-glyburide-and-insulin-in-the-management-of-gestational-diabetes-a-meta-analysis
#18
COMPARATIVE STUDY
Rongjing Song, Ling Chen, Yue Chen, Xia Si, Yi Liu, Yue Liu, David M Irwin, Wanyu Feng
OBJECTIVE: The aim of this meta-analysis was to determine the efficacy and safety of glyburide as a treatment for gestational diabetes mellitus (GDM) compared to insulin. METHODS: A meta-analysis was conducted to compare the management of gestational diabetes with glyburide and insulin. Studies fulfilling all of the following inclusion criteria were included in this meta-analysis: subjects were women with gestational diabetes requiring drug treatment; the comparison treatment included glyburide vs insulin; one or more outcomes (maternal or neonatal) should be provided in the individual study; the study design should be a randomized control trial...
2017: PloS One
https://www.readbyqxmd.com/read/28767190/insulin-degludec-in-the-first-trimester-of-pregnancy-report-of-two-cases
#19
Agostino Milluzzo, Andrea Tumminia, Nunzio M Scalisi, Lucia Frittitta, Riccardo Vigneri, Laura Sciacca
Insulin degludec is an extra-long-acting insulin analog that allows for enhanced efficacy and flexibility in the injection time. However, it is not approved for use during pregnancy. We report the pregnancy outcome and newborn conditions in two type 1 diabetic women who continued pre-conception degludec treatment during embryogenesis. No pregnancy complication or congenital neonatal malformation was observed. Both babies presented with hypoglycemia and required neonatal intensive care unit admission. Degludec treatment did not cause adverse effects in the mothers or malformations in the newborns...
August 2, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28764827/using-dextrose-glucose-gel-to-reverse-neonatal-hypoglycemia
#20
Patricia Scheans, Catherine Bennett, Deborah Harris
Hospitals are challenged to implement measures to improve health outcomes, decrease costly interventions, and increase patient satisfaction. By following a nurse-driven protocol, our institution has successfully met these three challenges in our treatment of newborns diagnosed with neonatal hypoglycemia (NH). Based on results of a randomized clinical trial, a multidisciplinary team trialed glucose gel as a standard treatment for NH. During the first year, admission rates to the NICU for NH decreased by 73 percent...
July 1, 2017: Neonatal Network: NN
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