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Neonatal hypoglycemia

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https://www.readbyqxmd.com/read/27925166/new-guidelines-for-screening-diagnosing-and-treating-gestational-diabetes-evaluation-of-maternal-and-neonatal-outcomes-in-finland-from-2006-to-2012
#1
Anni Ellenberg, Nanna Sarvilinna, Mika Gissler, Veli-Matti Ulander
INTRODUCTION: In this study, we have assessed the changes in pregnancy outcomes following the implementation of national guidelines for gestational diabetes mellitus (GDM). These national guidelines changed the screening policy from risk-based to comprehensive screening. MATERIAL AND METHODS: We designed a retrospective register-based cohort study based on the data from the Finnish Medical Birth Register and Hospital Discharge Register including 34 794 singleton births in 2006-2008 and 36 488 in 2010-2012...
December 7, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27922496/metabolic-myopathies
#2
Mark A Tarnopolsky
PURPOSE OF REVIEW: Metabolic myopathies are genetic disorders that impair intermediary metabolism in skeletal muscle. Impairments in glycolysis/glycogenolysis (glycogen-storage disease), fatty acid transport and oxidation (fatty acid oxidation defects), and the mitochondrial respiratory chain (mitochondrial myopathies) represent the majority of known defects. The purpose of this review is to develop a diagnostic and treatment algorithm for the metabolic myopathies. RECENT FINDINGS: The metabolic myopathies can present in the neonatal and infant period as part of more systemic involvement with hypotonia, hypoglycemia, and encephalopathy; however, most cases present in childhood or in adulthood with exercise intolerance (often with rhabdomyolysis) and weakness...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27921434/-actual-trends-in-diagnostics-and-treatment-of-congenital-hyperinsulinism
#3
Juraj Staník, Martina Škopková, Monika Rosoľanková, Iwar Klimeš, Daniela Gašperíková
Congenital hyperinsulinism (CHI) is the most common cause of severe persistent hypoglycemia in neonates and infants. Early diagnosis and effective treatment (based on the principles of pharmacogenetics) play the key role for the prognosis. The DNA anlysis, which can identify mutation in one of the 11 genes causing MODY, is crutial in the diagnostics. Moreover, The genotype determines also the optimal therapy approach (medicaments, diet or rarely surgery). There was a large progress of novel medicaments treating particularly most severe (diazoxide-resistant) forms of CHI...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27895948/pediatric-balint-s-syndrome-variant-a-possible-diagnosis-in-children
#4
Swetha Sara Philip, Sunithi Elizabeth Mani, Gordon N Dutton
Balint's syndrome is well described in adults, but not in children. It is caused by bilateral posterior parietal lobe damage and comprises a triad of simultanagnosia (inability to simultaneously see more than a small number of items), optic ataxia (impaired visual guidance of movement of the limbs and body), and apraxia of gaze (inability to volitionally direct gaze despite the requisite motor substrate) often associated with homonymous lower visual field loss. We, here, describe five children (four males, one female; mean age 7...
2016: Case Reports in Ophthalmological Medicine
https://www.readbyqxmd.com/read/27863107/heterogeneity-of-glycometabolism-in-patients-with-gestational-diabetes-mellitus
#5
Yan Yan, Zhou Liu, Daqing Liu
BACKGROUND: To evaluate the glycometabolism and outcomes of gestational diabetes mellitus (GDM) patients according to the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria in China. METHODS: According to the results of a 75-g OGTT, 1683 pregnant women were divided into three groups: an increment GDM group (patients meet the IADPSG criteria but not the previous Chinese criteria), a stock GDM group (patients meet both criteria), and a normal glucose tolerance (NGT) group...
November 10, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27844484/golden-60%C3%A2-minutes-of-newborn-s-life-part-2-term-neonate
#6
Deepak Sharma, Pradeep Sharma, Sweta Shastri
The concept of "Golden 60 minutes" or "Golden Hour" has been derived from adult trauma. It has been defined as the first 60 minutes of postnatal life. It has been seen that care received by any newborn in the initial first hour have implications in the future life, showing the importance of golden hour. The major cause of neonatal mortality term newborn is asphyxia, which can be reduced with effective resuscitation. In golden hour approach for term newborn, the importance is given to effective and evidence based resuscitation, post-resuscitation care, delayed cord clamping, prevention of hypothermia, immediate breast feeding, prevention of hypoglycemia, and starting of therapeutic hypothermia in case of moderate to severe asphyxia...
November 15, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27844483/golden-60%C3%A2-minutes-of-newborn-s-life-part-1-preterm-neonate
#7
Deepak Sharma
"Golden 60 minutes "or "Golden Hour" is defined as the first hour of the newborn after birth. This hour includes resuscitation care, transport to nursery from place of birth and course in nursery. The concept of "Golden hour" includes evidence based interventions that are done in the first 60 min of postnatal life for the better long term outcome of the preterm newborn especially extreme premature, extreme low birth weight and very low birth weight. The evidence shows that the concept of "Golden 60 minutes" leads to reduction in neonatal complications like hypothermia, hypoglycemia, intraventricular hemorrhage, chronic lung disease and retinopathy of prematurity...
December 1, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27824754/raspberry-leaf-and-hypoglycemia-in-gestational-diabetes-mellitus
#8
Kai I Cheang, Thanh T Nguyen, Nicole W Karjane, Kelsey E S Salley
BACKGROUND: Raspberry leaf is commonly consumed by pregnant women. Hypoglycemic effects have been documented with other species within the plant family. Whether raspberry leaf affects glycemic control in gestational diabetes mellitus (GDM) is unknown. CASE: A 38-year-old nulliparous woman with GDM developed hypoglycemia requiring lowered insulin dose after consuming raspberry leaf tea at 32 weeks of gestation. The temporal relationship was confirmed by the patient's self-withdrawal and reintroduction of the herb...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27817881/the-effect-of-early-feeding-on-initial-glucose-concentrations-in-term-newborns
#9
Yin Zhou, Shasha Bai, Joshua A Bornhorst, Nahed O Elhassan, Jeffrey R Kaiser
OBJECTIVE: To evaluate the influence of early feeding on initial glucose concentrations in healthy term newborns who were not at risk for hypoglycemia. STUDY DESIGN: This retrospective observational study was conducted at the University of Arkansas for Medical Sciences where universal early glucose screening was standard of care for newborn infants. Plasma glucose concentrations were compared in term infants born in 2008 who were not at risk for neonatal hypoglycemia and who were fed before (early feeders) and after (late feeders) their initial glucose screens...
November 3, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27817766/-clinical-effect-and-safety-of-somatostatin-in-treatment-of-postoperative-gastrointestinal-bleeding-in-neonates
#10
Bo-Xiang Qi, Lei Zhu, Lei Shang, Li-Ping Sheng, Bao-Li Hu, Kun Gao
OBJECTIVE: To investigate the clinical effect and safety of somatostatin in the treatment of postoperative gastrointestinal bleeding in neonates. METHODS: A prospective randomized study was performed, and 126 neonates who underwent surgery for congenital gastrointestinal anomalies were randomly divided into control group, treatment group A, and treatment group B. The neonates in the control group were given routine postoperative hemostasis, and those in the treatment groups were given somatostatin in addition to the treatment for the control group...
November 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/27809283/effect-of-high-carbohydrate-diet-on-plasma-metabolome-in-mice-with-mitochondrial-respiratory-chain-complex-iii-deficiency
#11
Jayasimman Rajendran, Nikica Tomašić, Heike Kotarsky, Eva Hansson, Vidya Velagapudi, Jukka Kallijärvi, Vineta Fellman
Mitochondrial disorders cause energy failure and metabolic derangements. Metabolome profiling in patients and animal models may identify affected metabolic pathways and reveal new biomarkers of disease progression. Using liver metabolomics we have shown a starvation-like condition in a knock-in (Bcs1l(c.232A>G)) mouse model of GRACILE syndrome, a neonatal lethal respiratory chain complex III dysfunction with hepatopathy. Here, we hypothesized that a high-carbohydrate diet (HCD, 60% dextrose) will alleviate the hypoglycemia and promote survival of the sick mice...
November 1, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27806559/investigation-the-effects-of-metformin-versus-insulin-on-neonatal-and-maternal-outcomes-in-women-with-gestational-diabetes-mellitus-a-randomized-clinical-trail
#12
Mahin Najafian, Mojgan Barati, Sara Masihi, Ailin Fardipor
The aim of this study was to evaluate the effectiveness of metformin versus insulin in the glycemic control and to investigate the maternal and neonatal outcomes in in women with gestational diabetes mellitus. Pregnant women with gestational diabetes were randomized to either receive metformin (n=70) or insulin (n=70). Inclusion criteria were singleton pregnancy, following healthy diet and performing exercise for at least one week without satisfactory blood glucose level, no risk factor contributing to lactic acidosis, and no anatomic and/or chromosome anomalies...
September 28, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27802864/glucokinase-mutation-a-rare-cause-of-recurrent-hypoglycemia-in-adults-a-case-report-and-literature-review
#13
Oluremi N Ajala, David M Huffman, Ibrahim I Ghobrial
BACKGROUND: Hypoglycemia occurs frequently in patients both in the inpatient and outpatient settings. While most hypoglycemia unrelated to diabetes treatment results from excessive endogenous insulin action, rare cases involve functional and congenital mutations in glycolytic enzymes of insulin regulation. CASE: A 21-year-old obese woman presented to the emergency department with complaints of repeated episodes of lethargy, syncope, dizziness, and sweating. She was referred from an outside facility on suspicion of insulinoma, with severe hypoglycemia unresponsive to repeated dextrose infusions...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27785616/pepck-c-reexpression-in-the-liver-counters-neonatal-hypoglycemia-in-pck1-del-del-mice-unmasking-role-in-non-gluconeogenic-tissues
#14
Jana Semakova, Petra Hyroššová, Andrés Méndez-Lucas, Ernest Cutz, Jordi Bermudez, Shawn Burgess, Soledad Alcántara, José C Perales
Whole body cytosolic phosphoenolpyruvate carboxykinase knockout (PEPCK-C KO) mice die early after birth with profound hypoglycemia therefore masking the role of PEPCK-C in adult, non-gluconeogenic tissues where it is expressed. To investigate whether PEPCK-C deletion in the liver was critically responsible for the hypoglycemic phenotype, we reexpress this enzyme in the liver of PEPCK-C KO pups by early postnatal administration of PEPCK-C-expressing adenovirus. This maneuver was sufficient to partially rescue hypoglycemia and allow the pups to survive and identifies the liver as a critical organ, and hypoglycemia as the critical pathomechanism, leading to early postnatal death in the whole-body PEPCK-C knockout mice...
October 26, 2016: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/27764194/vitamin-d-deficiency-increases-the-risk-of-adverse-neonatal-outcomes-in-gestational-diabetes
#15
Letícia Schwerz Weinert, Angela Jacob Reichelt, Leonardo Rauber Schmitt, Roberta Boff, Maria Lucia Rocha Oppermann, Joiza Lins Camargo, Sandra Pinho Silveiro
BACKGROUND: Gestational diabetes mellitus (GDM) and vitamin D deficiency have been associated with increased risk of adverse perinatal outcomes but the consequences of both conditions simultaneously present in pregnancy have not yet been evaluated. Our objective was to study the influence of vitamin D deficiency in neonatal outcomes of pregnancies with GDM. METHODS: 184 pregnant women with GDM referred to specialized prenatal monitoring were included in this cohort and had blood sampled for 25-hydroxyvitamin D measurement...
2016: PloS One
https://www.readbyqxmd.com/read/27756175/pregnancies-complicated-by-both-preeclampsia-and-growth-restriction-between-34-and-37-weeks-gestation-are-associated-with-adverse-perinatal-outcomes
#16
Kathryn J Sharma, Tania F Esakoff, Alyson Guillet, Richard M Burwick, Aaron B Caughey
OBJECTIVE: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. METHODS: This was a retrospective cohort study of 8,927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birthweight <10(th) percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27753189/congenital-hypoglycemia-disorders-new-aspects-of-etiology-diagnosis-treatment-and-outcomes-highlights-of-the-proceedings-of-the-congenital-hypoglycemia-disorders-symposium-philadelphia-april-2016
#17
Diva D De Leon, Charles A Stanley
Hypoglycemia continues to be an important cause of morbidity in neonates and children. Prompt diagnosis and management of the underlying hypoglycemia disorder is critical for preventing brain damage and improving outcomes. Congenital hyperinsulinism (HI) is the most common and severe cause of persistent hypoglycemia in neonates and children. Recent discoveries of the genetic causes of HI have improved our understanding of the pathophysiology, but its management is complex and requires the integration of clinical, biochemical, molecular, and imaging findings to establish the appropriate treatment according to the subtype...
October 18, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27752317/improving-the-diagnosis-of-neonatal-hypoglycemia-in-a-well-baby-nursery
#18
Eric Ly, Jennifer Alexander, Temi Akinmboni, Hyung Woo, Colleen Driscoll
Point of care glucose (POCG) measurements, used for detecting neonatal hypoglycemia, can have variable accuracy. The appropriate diagnosis of neonatal hypoglycemia in babies with low POCG measurements involves confirmatory serum glucose (CSG) testing. At our institution, no babies with low POCG measurements had CSG testing in their evaluation of neonatal hypoglycemia over a three year period. Our aim was to increase the percentage of CSG testing in babies with a low POCG. A secondary aim was to decrease the percentage of low-risk, asymptomatic babies who received POCG testing...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27751224/-an-analysis-of-clinical-characteristics-and-gene-mutation-in-two-patients-with-medium-and-short-chain-acyl-coa-dehydrogenase-deficiency
#19
Jian-Qiang Tan, Da-Yu Chen, Zhe-Tao Li, Ji-Wei Huang, Ti-Zhen Yan, Ren Cai
Medium- and short-chain acyl-CoA dehydrogenase deficiency is a disorder of fatty acid β-oxidation. Gene mutation prevents medium- and short-chain fatty acids from entry into mitochondria for oxidation, which leads to multiple organ dysfunction. In this study, serum acylcarnitines and the organic acid profile in urea were analyzed in two children whose clinical symptoms were hypoglycemia and metabolic acidosis. Moreover, gene mutations in the two children and their parents were evaluated. One of the patients was a 3-day-old male who was admitted to the hospital due to neonatal asphyxia, sucking weakness, and sleepiness...
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/27735930/prenatal-visit-utilization-and-outcomes-in-pregnant-women-with-type-ii-and-gestational-diabetes
#20
E B Carter, M G Tuuli, A O Odibo, G A Macones, A G Cahill
OBJECTIVE: To investigate the association between the number of prenatal visits (PNVs) and pregnancy outcomes in women with gestational diabetes (GDM) and Type 2 diabetes mellitus (DM). STUDY DESIGN: A 4-year prospective cohort study of women with GDM and DM and was conducted. Patients ⩾75th percentile for number of PNVs were compared with those ⩽25th percentile. The primary outcomes were large for gestational age (LGA) with birth weight >90% and neonatal intensive care unit (NICU) admission for >24 h...
October 13, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
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