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Neonatal hypoglycaemia

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https://www.readbyqxmd.com/read/29331007/anaesthetic-management-of-nesidioblastosis-in-two-infants
#1
Muhammad Saad Yousuf, Mohsin Nazir Butt, Fauzia Anis Khan
Nesidioblastosis is the most common cause of non-transient, recurrent and persistent hypoglycaemia in neonates and infants. It is a disorder of diffuse proliferation of beta cells of the pancreas leading to hyperinsulinemia and hypoglycaemia. The main aim is to prevent the severe episodes of hypoglycaemia which can cause damage to the brain and/or mental retardation. In this case report we present two cases of nesidioblastosis and their perioperative anaesthetic course for near-total pancreatectomy. First case was a 7 months old female who had repeated episodes of convulsions since birth...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29325773/how-safe-is-metformin-when-initiated-in-early-pregnancy-a-retrospective-5-year-study-of-pregnant-women-with-gestational-diabetes-mellitus-from-india
#2
Vanlalhruaii, Riddhi Dasgupta, Roshna Ramachandran, Jiji E Mathews, Annie Regi, Niranjan Thomas, Vijay Gupta, P Visalakshi, H S Asha, Thomas Paul, Nihal Thomas
BACKGROUND: The initiation of metformin in early pregnancy in Gestational Diabetes mellitus(GDM) remains controversial. The aim of our study was to assess the influence of Metformin on maternal and fetal outcomes when initiated within the first trimester of pregnancy in GDM. METHODS AND MATERIALS: A retrospective analysis of 540 women with diabetes complicating pregnancy (IADPSG criteria) over five years(January 2011 to May 2016)was done. The study population comprised of patients initiated on a)metformin within the first trimester (Group A:n=186),b) metformin after the first trimester(Group B:n=203) and c)insulin at any time during their pregnancy(Group C:n=151)...
January 8, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29284716/burden-of-early-term-birth-on-adverse-infant-outcomes-a-population-based-cohort-study-in-brazil
#3
Maria do Carmo Leal, Ana Paula Esteves-Pereira, Marcos Nakamura-Pereira, Rosa Maria Soares Madeira Domingues, Marcos Augusto Bastos Dias, Maria Elisabeth Moreira, Mariza Theme-Filha, Silvana Granado Nogueira da Gama
OBJECTIVES: To estimate the national rate of early-term live births in Brazil and to evaluate the effect of birth at 37 and 38 weeks' gestation, as compared with 39 and 40 weeks' gestation on infant outcomes according to precursors of birth and the existence of maternal/fetal medical conditions. DESIGN: National perinatal population-based cohort study. SETTING: 266 maternity services located in the five Brazilian macroregions. PARTICIPANTS: 18 652 singleton live newborns from 37 0/7 to 40 6/7 weeks of gestation...
December 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/29280746/congenital-hyperinsulinism-diagnosis-and-treatment-update
#4
Hüseyin Demirbilek, Khalid Hussain
Pancreatic β-cells are finely tuned to secrete insulin so that plasma glucose levels are maintained within a narrow physiological range (3.5-5.5 mmol/L). Hyperinsulinaemic hypoglycaemia (HH) is the inappropriate seretion of insulin in the presence of low plasma glucose levels and leads to severe and persistent hypoglycaemia in neonates and children. Mutations in 12 different key genes (ABCC8, KCNJ11, GLUD1, GCK, HADH, SLC16A1, UCP2, HNF4A, HNF1A, HK1, PGM1 and PMM2) that are involved in the regulation of insulin secretion from pancreatic β-cells have been described to be responsible for the underlying molecular mechanisms leading to congenital HH...
December 27, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29193322/vision-screening-at-two-years-does-not-reduce-the-prevalence-of-reduced-vision-at-four-and-a-half-years-of-age
#5
Lucy Goodman, Arijit Chakraborty, Nabin Paudel, Tzu-Ying Yu, Robert J Jacobs, Jane E Harding, Benjamin Thompson, Nicola S Anstice
BACKGROUND: There is currently insufficient evidence to recommend vision screening for children < 36 months of age. This study assessed the effect of comprehensive vision screening, as well as the sensitivity of age-appropriate vision tests, at two years of age on habitual visual acuity at 4.5 years of age. METHODS: Children born at risk of neonatal hypoglycaemia (n = 477) underwent vision assessment at 54 ± 2 months of age including measurement of monocular and binocular habitual visual acuity, assessment of binocularity and stereopsis...
November 28, 2017: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/29170288/midwife-or-doctor-local-opinion-leader-to-implement-a-national-guideline-in-babies-on-postnatal-wards-design-protocol-of-a-cluster-randomised-blinded-controlled-trial
#6
Jane Marie Alsweiler, Caroline A Crowther, Jane E Harding
INTRODUCTION: Neonatal hypoglycaemia is a common condition that can cause developmental delay. Treatment of neonatal hypoglycaemia with oral dextrose gel has been shown to reverse hypoglycaemia and reduce admissions to neonatal intensive care for hypoglycaemia. An evidence-based clinical practice guideline was written to guide the use of dextrose gel to treat neonatal hypoglycaemia in New Zealand. However, it is unclear what clinical discipline might most effectively lead the implementation of the guideline recommendations...
November 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29129039/combined-diet-and-exercise-interventions-for-preventing-gestational-diabetes-mellitus
#7
REVIEW
Emily Shepherd, Judith C Gomersall, Joanna Tieu, Shanshan Han, Caroline A Crowther, Philippa Middleton
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with a wide range of adverse health consequences for women and their infants in the short and long term. With an increasing prevalence of GDM worldwide, there is an urgent need to assess strategies for GDM prevention, such as combined diet and exercise interventions. This is an update of a Cochrane review that was first published in 2015. OBJECTIVES: To assess the effects of diet interventions in combination with exercise interventions for pregnant women for preventing GDM, and associated adverse health consequences for the mother and her infant/child...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29117445/intrapartum-glycaemic-control-and-neonatal-hypoglycaemia-in-pregnancies-complicated-by-diabetes-mellitus-a-systematic-review
#8
J M Yamamoto, J Benham, K Mohammad, L E Donovan, S Wood
AIMS: To examine whether, in neonates of mothers with Type 1, Type 2 and gestational diabetes mellitus, in-target intrapartum glycaemic control was associated with a lower risk of neonatal hypoglycaemia compared with out-of-target glycaemic control. METHODS: We searched PubMed and EMBASE for all available publications, regardless of year, based on a published protocol (PROSPERO CRD42016052439). Studies were excluded if they did not report original data or were animal studies...
November 8, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29103210/insulin-for-the-treatment-of-women-with-gestational-diabetes
#9
REVIEW
Julie Brown, Luke Grzeskowiak, Kathryn Williamson, Michelle R Downie, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with short- and long-term complications for the mother and her infant. Women who are unable to maintain their blood glucose concentration within pre-specified treatment targets with diet and lifestyle interventions will require anti-diabetic pharmacological therapies. This review explores the safety and effectiveness of insulin compared with oral anti-diabetic pharmacological therapies, non-pharmacological interventions and insulin regimens...
November 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29102365/pregnancy-in-women-with-a-cardiomyopathy-outcomes-and-predictors-from-a-retrospective-cohort
#10
Gilles Billebeau, Martin Etienne, Riadh Cheikh-Khelifa, Daniele Vauthier-Brouzes, Estelle Gandjbakhch, Richard Isnard, Jacky Nizard, Michel Komajda, Marc Dommergues, Philippe Charron
BACKGROUND: Pregnancies in women with pre-existing cardiomyopathies are considered at high risk for complications. However, few data are available to characterize their natural history and predict the outcome. AIMS: Our aim was to evaluate the prevalence and predictors of acute cardiac and obstetric events in women with a cardiomyopathy during pregnancy, excluding peripartum cardiomyopathy. METHODS: In this retrospective study in a referral centre for cardiomyopathies, we included 43 consecutive pregnancies in 36 women with dilated, hypertrophic, arrhythmogenic right ventricular or tachycardia-induced cardiomyopathy, or left ventricular non-compaction...
October 25, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29100893/-late-preterm-infants-in-spain-experience-of-the-34-36-neonatal-group
#11
Mercedes García-Reymundo, Xavier Demestre, M José Calvo, Gemma Ginovart, Ana Jiménez, José Antonio Hurtado
INTRODUCTION: Late preterm (LP) infants (34 -36 weeks of gestation) are the largest group of preterm infants and also the least studied so far. In order to improve their care and reduce the impact of their increased morbidity and mortality, it is essential to know the current situation in Spain. POPULATION AND METHOD: Clinical-epidemiological variables of the LP population of 34 participating hospitals were prospectively collected from 1 April 2011 to 31 March 2016, and were then compared with the Minimum Perinatal Data Set for term births in the database...
October 31, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29081069/different-methods-and-settings-for-glucose-monitoring-for-gestational-diabetes-during-pregnancy
#12
REVIEW
Puvaneswary Raman, Emily Shepherd, Therese Dowswell, Philippa Middleton, Caroline A Crowther
BACKGROUND: Incidence of gestational diabetes mellitus (GDM) is increasing worldwide. Blood glucose monitoring plays a crucial part in maintaining glycaemic control in women with GDM and is generally recommended by healthcare professionals. There are several different methods for monitoring blood glucose which can be carried out in different settings (e.g. at home versus in hospital). OBJECTIVES: The objective of this review is to compare the effects of different methods and settings for glucose monitoring for women with GDM on maternal and fetal, neonatal, child and adult outcomes, and use and costs of health care...
October 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29077992/population-pharmacokinetics-of-exendin-9-39-and-clinical-dose-selection-in-patients-with-congenital-hyperinsulinism
#13
Chee M Ng, Fei Tang, Steven Seeholzer, Yixuan Zou, Diva D De León
AIMS: Congenital hyperinsulinism (HI) is the most common cause of persistent hypoglycaemia in infants and children. Exendin-(9-39), an inverse glucagon-like peptide 1 (GLP-1) agonist, is a novel therapeutic agent for HI that has demonstrated glucose-raising effect. We reported the first population pharmacokinetic (PopPK) model of the exendin-(9-39) in patients with HI and proposed the optimal dosing regimen for future clinical trials in neonates with HI. METHODS: 182 pharmacokinetic (PK) observations from 26 subjects in three clinical studies were included for constructing the PopPK model using FOCE with interaction method in NONMEM...
October 27, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29076132/moderate-to-late-preterm-intrauterine-growth-restriction-a-restrospective-observational-study-of-the-indications-for-delivery-and-outcomes-in-an-australian-perinatal-centre
#14
Bridie Stewart, Amalia Karahalios, Rosalynn Pszczola, Joanne Said
BACKGROUND: The management of preterm intrauterine growth restriction is limited to fetal surveillance and timely delivery. Despite the existence of evidence-based guidelines, uncertainty regarding the optimal timing of delivery is common, and management remains individualised for each patient. AIMS: To provide recent Australian data on the indications for delivery of moderate to late preterm growth restricted infants and the outcomes of these deliveries. MATERIALS AND METHODS: Retrospective study of singleton live births delivered between 32 + 0 and 36 + 6 weeks gestation over a three-year period (2012-2014) at a Melbourne Metropolitan Hospital...
October 27, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29051825/continuous-glucose-monitoring-in-neonates-a-review
#15
REVIEW
Christopher J D McKinlay, J Geoffrey Chase, Jennifer Dickson, Deborah L Harris, Jane M Alsweiler, Jane E Harding
Continuous glucose monitoring (CGM) is well established in the management of diabetes mellitus, but its role in neonatal glycaemic control is less clear. CGM has provided important insights about neonatal glucose metabolism, and there is increasing interest in its clinical use, particularly in preterm neonates and in those in whom glucose control is difficult. Neonatal glucose instability, including hypoglycaemia and hyperglycaemia, has been associated with poorer neurodevelopment, and CGM offers the possibility of adjusting treatment in real time to account for individual metabolic requirements while reducing the number of blood tests required, potentially improving long-term outcomes...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29045765/oral-anti-diabetic-agents-for-women-with-established-diabetes-impaired-glucose-tolerance-or-previous-gestational-diabetes-planning-pregnancy-or-pregnant-women-with-pre-existing-diabetes
#16
REVIEW
Joanna Tieu, Suzette Coat, William Hague, Philippa Middleton, Emily Shepherd
BACKGROUND: While most guidance recommends the use of insulin in women whose pregnancies are affected by pre-existing diabetes, oral anti-diabetic agents may be more acceptable to women. The effects of these oral anti-diabetic agents on maternal and infant health outcomes need to be established in pregnant women with pre-existing diabetes or impaired glucose tolerance, as well as in women with previous gestational diabetes mellitus preconceptionally or during a subsequent pregnancy. This review is an update of a review that was first published in 2010...
October 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29022989/prophylactic-intravenous-calcium-therapy-for-exchange-blood-transfusion-in-the-newborn
#17
REVIEW
Tinuade A Ogunlesi, Foluso Ea Lesi, Olabisi Oduwole
BACKGROUND: Exchange blood transfusion (EBT) is a form of whole blood transfusion in which the total blood volume is replaced within a few hours. In perinatal and neonatal medicine, EBT is most often used in the management of severe anaemia or severe hyperbilirubinaemia in the first week of life. Hypocalcaemia, one of the common morbidities associated with EBT, is thought to arise from the chelating effects of the citrate commonly used as an anticoagulant in the donor's blood. This disorder manifests with muscular and nervous irritability and cardiac arrhythmias...
October 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28992707/-overgrowth-in-children-and-in-adults-novel-clinical-view-novel-genes-novel-phenotypes
#18
Jan Lebl, Lukáš Plachý, Květa Bláhová, Lenka Elblová, Filip Fencl, Stanislava Koloušková, Štěpánka Průhová
Novel genetic findings allow to more reliably elucidate the aetiology and pathogenesis of overgrowth syndromes in children and in adults. The relatively prevalent overgrowth syndromes in foetuses and neonates include Beckwith-Wiedemann (BWS) and Sotos syndromes; in addition, several rare conditions may occur e.g. Simpson-Golabi-Behmel and Weaver syndromes. These syndromes are not connected with overproduction of growth hormone. Their carriers are at risk of hypoglycaemia (in BWS), of congenital malformations and of childhood tumours...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28991764/hypoglycaemia-in-the-newborn
#19
Orhideja Stomnaroska, Elizabeta Petkovska, Sanja Ivanovska, Snezana Jancevska, Dragan Danilovski
AIM: Severe neonatal hypoglycaemia (HG) leads to neurologic damage, mental retardation, epilepsy, impaired cardiac performance and muscle weakness. The aim was to assess the frequency and severity of HG in a population of newborns. PATIENTS AND METHODS: We investigated 739 patients with neonatal hypoglycaemia (HG) (M:F=370:369) born at the University Clinic for Gynaecology and Obstetritics in Skopje in the period 2014-2016 and treated at the neonatal intensive care unit (NICU)...
September 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28948952/efficacy-of-metformin-in-improving-glycaemic-control-perinatal-outcome-in-gestational-diabetes-mellitus-a-non-randomized-study
#20
Neeta Singh, Malti Madhu, Perumal Vanamail, Nisha Malik, Sunesh Kumar
BACKGROUND & OBJECTIVES: Gestational diabetes mellitus (GDM) can cause adverse perinatal outcome if not treated. Although insulin therapy has been the main treatment modality over decades but considering its cost and parenteral mode of administration, it does not seem to be appropriate, especially in low-resource settings. The objective of this study was to evaluate the role of metformin in GDM and know its efficacy as well as adverse effect on foetus and mother. METHODS: All pregnant women with GDM who were not controlled on medical nutrition therapy and required metformin therapy were included in the study...
May 2017: Indian Journal of Medical Research
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