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Neonatal hypoglycaemia

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https://www.readbyqxmd.com/read/28397655/-liver-failure-in-neonatal-children-is-a-diagnostic-challenge
#1
Heidi Smedegaard, Vibeke Brix Christensen, Morten Hanefeld Dziegiel, Marianne Hørby Jørgensen
This case report presents a newborn boy with hypoglycaemia, anaemia, jaundice and severe coagulopathy during the first day of his life, imitating sepsis and disseminated intravascular coagulation. One week after the birth he was diagnosed with acute liver failure due to gestational alloimmune liver disease (GALD). Despite the fact that GALD is rare, it must be suspected in all unexplained stillborn children and infants with severe liver disease. If diagnosed, it is possible to prevent death and severe liver failure in future newborns by treating the affected women with immunoglobulin during pregnancy...
March 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28389437/paediatric-hypoglycaemia-are-we-investigating-appropriately-and-adequately
#2
Louise Ramsden, Katherine Wright, Anuja Natarajan
INTRODUCTION: Paediatric hypoglycaemia is a relatively common medical emergency. To allow identification of the underlying cause, investigations need to be performed urgently prior to treatment being given. Careful consideration is needed to ensure correct patient selection, as inadequate investigations have further cost and patient safety implications. METHODS: 49 cases of proven or suspected hypoglycaemia (glucose ≤2.6 mmol/L) were identified via the laboratory...
April 6, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28266082/dietary-epigallocatechin-3-gallate-supplement-improves-maternal-and-neonatal-treatment-outcome-of-gestational-diabetes-mellitus-a-double-blind-randomised-controlled-trial
#3
H Zhang, S Su, X Yu, Y Li
BACKGROUND: Gestational diabetes mellitus (GDM) is an increasing prevalent health risk in pregnant women. Epigallocatechin 3-gallate (EGCG) is known to benefit the insulin secretory machinery. We aimed to investigate the effect of daily dietary EGCG supplementation on both the maternal and neonatal treatment outcomes in GDM-affected pregnancies. METHODS: In total, 472 pregnant women during their third trimester of pregnancy were diagnosed with GDM and subsequently enrolled into this trial...
March 6, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28264826/computer-determined-dosage-of-insulin-in-the-management-of-neonatal-hyperglycaemia-hint2-protocol-of-a-randomised-controlled-trial
#4
Jane Alsweiler, Kathryn Williamson, Frank Bloomfield, Geoffrey Chase, Jane Harding
INTRODUCTION: Neonatal hyperglycaemia is frequently treated with insulin, which may increase the risk of hypoglycaemia. Computer-determined dosage of insulin (CDD) with the STAR-GRYPHON program uses a computer model to predict an effective dose of insulin to treat hyperglycaemia while minimising the risk of hypoglycaemia. However, CDD models can require more frequent blood glucose testing than common clinical protocols. The aim of this trial is to determine if CDD using STAR-GRYPHON reduces hypoglycaemia in hyperglycaemic preterm babies treated with insulin independent of the frequency of blood glucose testing...
March 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28253512/neonatal-hypoglycaemia-and-visual-development-a-review
#5
Nabin Paudel, Arijit Chakraborty, Nicola Anstice, Robert J Jacobs, Jo E Hegarty, Jane E Harding, Benjamin Thompson
BACKGROUND: Many newborn babies experience low blood glucose concentrations, a condition referred to as neonatal hypoglycaemia (NH). The effect of NH on visual development in infancy and childhood is of interest because the occipital lobes, which include the primary visual cortex and a number of extrastriate visual areas, may be particularly susceptible to NH-induced injury. In addition, a number of case series have suggested that NH can affect eye and optic nerve development. OBJECTIVE: To review the existing literature concerning the effect of NH on the visual system...
March 3, 2017: Neonatology
https://www.readbyqxmd.com/read/28236296/different-types-of-dietary-advice-for-women-with-gestational-diabetes-mellitus
#6
REVIEW
Shanshan Han, Philippa Middleton, Emily Shepherd, Emer Van Ryswyk, Caroline A Crowther
BACKGROUND: Dietary advice is the main strategy for managing gestational diabetes mellitus (GDM). It remains unclear what type of advice is best. OBJECTIVES: To assess the effects of different types of dietary advice for women with GDM for improving health outcomes for women and babies. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (8 March 2016), PSANZ's Trials Registry (22 March 2016) and reference lists of retrieved studies...
February 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28220533/does-dextrose-gel-prevent-treatment-failure-in-infants-with-neonatal-hypoglycaemia
#7
Stephanie L Bourque, Paul J Rozance
No abstract text is available yet for this article.
February 20, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28199038/the-duration-of-intrapartum-maternal-hyperglycaemia-predicts-neonatal-hypoglycaemia-in-women-with-pre-existing-diabetes
#8
T Joshi, C Oldmeadow, J Attia, K Wynne
AIM: There is a high incidence of neonatal hypoglycaemia in neonates born to mothers with pre-existing diabetes. This often necessitates admission to the neonatal intensive care. Guidelines suggest maintaining intrapartum blood glucose levels (BGLs) of 4-7 mmol/l in women with diabetes to reduce the risk of neonatal hypoglycaemia. This study assessed whether intrapartum BGLs in women with pre-gestational Type 1 and 2 diabetes were predictive of neonatal hypoglycaemia. METHODS: A retrospective analysis of 261 births delivered at a tertiary hospital in Australia from 2009 to 2014...
May 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28122797/single-dose-of-prophylactic-oral-dextrose-gel-reduces-neonatal-hypoglycaemia
#9
Praveen Chandrasekharan, Satyan Lakshminrusimha
No abstract text is available yet for this article.
January 25, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28120427/oral-anti-diabetic-pharmacological-therapies-for-the-treatment-of-women-with-gestational-diabetes
#10
REVIEW
Julie Brown, Ruth Martis, Brenda Hughes, Janet Rowan, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is a major public health issue with rates increasing globally. Gestational diabetes, glucose intolerance first recognised during pregnancy, usually resolves after birth and is associated with short- and long-term complications for the mother and her infant. Treatment options can include oral anti-diabetic pharmacological therapies. OBJECTIVES: To evaluate the effects of oral anti-diabetic pharmacological therapies for treating women with GDM...
January 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28114415/managing-neonatal-and-early-childhood-syndromic-sepsis-in-sub-district-hospitals-in-resource-poor-settings-improvement-in-quality-of-care-through-introduction-of-a-package-of-interventions-in-rural-bangladesh
#11
Ahmed Ehsanur Rahman, Afrin Iqbal, D M Emdadul Hoque, Md Moinuddin, Sojib Bin Zaman, Qazi Sadeq-Ur Rahman, Tahmina Begum, Atique Iqbal Chowdhury, Rafiqul Haider, Shams El Arifeen, Niranjan Kissoon, Charles P Larson
INTRODUCTION: Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments...
2017: PloS One
https://www.readbyqxmd.com/read/28100192/design-and-rationale-of-a-large-international-prospective-cohort-study-to-evaluate-the-occurrence-of-malformations-and-perinatal-neonatal-death-using-insulin-detemir-in-pregnant-women-with-diabetes-in-comparison-with-other-long-acting-insulins
#12
Elisabeth R Mathiesen, Henning Andersen, Sofia I I Kring, Peter Damm
BACKGROUND: There are a lack of data regarding the effect of basal insulin analogues on rates of events like congenital malformation and perinatal mortality in diabetic pregnancy. METHODS: The present study is a prospective, non-interventional, multicentre cohort study conducted in seven countries, designed to assess the safety of insulin detemir during pregnancy, and to monitor the health status of resulting infants (exposed in utero) up to 1 year of age. The study population includes women with type 1 or type 2 diabetes, who are pregnant and being treated with insulin...
January 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28046205/dietary-advice-interventions-in-pregnancy-for-preventing-gestational-diabetes-mellitus
#13
REVIEW
Joanna Tieu, Emily Shepherd, Philippa Middleton, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is a form of diabetes occurring during pregnancy which can result in short- and long-term adverse outcomes for women and babies. With an increasing prevalence worldwide, there is a need to assess strategies, including dietary advice interventions, that might prevent GDM. OBJECTIVES: To assess the effects of dietary advice interventions for preventing GDM and associated adverse health outcomes for women and their babies...
January 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27989586/an-emerging-evidence-base-for-the-management-of-neonatal-hypoglycaemia
#14
REVIEW
Jane E Harding, Deborah L Harris, Joanne E Hegarty, Jane M Alsweiler, Christopher Jd McKinlay
Neonatal hypoglycaemia is common, and screening and treatment of babies considered at risk is widespread, despite there being little reliable evidence upon which to base management decisions. Although there is now evidence about which babies are at greatest risk, the threshold for diagnosis, best approach to treatment and later outcomes all remain uncertain. Recent studies suggest that treatment with dextrose gel is safe and effective and may help support breast feeding. Thresholds for intervention require a wide margin of safety in light of information that babies with glycaemic instability and with low glucose concentrations may be associated with a higher risk of later higher order cognitive and learning problems...
January 2017: Early Human Development
https://www.readbyqxmd.com/read/27921429/-congenital-hyperinsulinism-loss-of-b-cell-self-control
#15
Jan Lebl, Klára Roženková, Štěpánka Průhová
Congenital hyperinsulinism is a serious blood glucose regulation defect that interferes with brain development, leading to mental retardation, neurological sequelae and secondary epilepsy and ultimately may be life-threatening. Congenital hyperinsulinism (CHI) is caused by genetic defects of regulation of insulin secretion that induce insulin oversecretion in intrauterine life and postnatally. The clinical consequence is fetal macrosomia and subsequently neonatal and infantile hypoglycaemia. The most severe form is caused by biallelic mutations of KCNJ11 and ABCC8 genes that encode both potassium channel subunits, whereas their heterozygous mutations as well as enzymatic defects (GLUD1, HADH, GCK) lead to milder presentation...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27915035/hyperinsulinaemic-hypoglycaemia-in-children-and-adults
#16
REVIEW
Pratik Shah, Sofia A Rahman, Huseyin Demirbilek, Maria Güemes, Khalid Hussain
Pancreatic β cells are functionally programmed to release insulin in response to changes in plasma glucose concentration. Insulin secretion is precisely regulated so that, under normal physiological conditions, fasting plasma glucose concentrations are kept within a narrow range of 3·5-5·5 mmol/L. In hyperinsulinaemic hypoglycaemia, insulin secretion becomes dysregulated (ie, uncoupled from glucose metabolism) so that insulin secretion persists in the presence of low plasma glucose concentrations. Hyperinsulinaemic hypoglycaemia is the most common cause of severe and persistent hypoglycaemia in neonates and children...
November 30, 2016: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27901638/atlantic-dip-insulin-therapy-for-women-with-iadpsg-diagnosed-gestational-diabetes-mellitus-does-it-work
#17
Delia Bogdanet, Aoife M Egan, Catriona Reddin, Oratile Kgosidialwa, Breda Kirwan, Louise Carmody, Fidelma P Dunne
Introduction: Approximately 40% of women with gestational diabetes mellitus (GDM) diagnosed using International Association of the Diabetes and Pregnancy Study Group (IADPSG) criteria require insulin therapy. Objective: We assessed whether the outcomes for women with GDM treated with insulin are comparable to women with normal glucose tolerance (NGT). Materials and Methods: This retrospective cohort study included 752 women with insulin-treated GDM and 2496 women with NGT during pregnancy...
March 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27873370/the-magnitude-of-change-in-the-fetal-cerebroplacental-ratio-in-the-third-trimester-and-the-risk-of-adverse-pregnancy-outcome
#18
Christopher Flatley, Ristan M Greer, Sailesh Kumar
OBJECTIVE: The primary aim of this study was to evaluate if the magnitude of change in the cerebro-placental ratio (CPR) after 30 weeks gestation was better predictive of adverse pregnancy outcome compared to a single measurement at 35-37 weeks. A secondary aim was to evaluate whether the utility of CPR measured at 35-37 weeks was enhanced after adjusting for the gestational change. METHODS: This was a retrospective cohort study of women who had had at least two ultrasound scans between 30-37 weeks gestation with the final scan taking place at 35-37 weeks...
November 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27862529/implementation-of-dextrose-gel-in-the-management-of-neonatal-hypoglycaemia
#19
Marene Ter, Ikhwan Halibullah, Laura Leung, Susan Jacobs
AIM: The aim of this study was to evaluate dextrose gel in the management of neonatal hypoglycaemia in the postnatal wards at an Australian tertiary level perinatal centre. METHODS: An audit was performed before and after implementation of dextrose gel. Pre-implementation, neonatal hypoglycaemia was managed with feed supplementation alone, and dextrose gel was used in addition to feed supplementation in the post-implementation phase. Outcomes included admission to neonatal intensive care unit (NICU) for management of hypoglycaemia, proportion of neonates who achieved normoglycaemia (defined as blood glucose ≥2...
April 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/27855235/sirolimus-therapy-in-a-child-with-partially-diazoxide-responsive-hyperinsulinaemic-hypoglycaemia
#20
Kah-Yin Loke, Andrew Sng Anjian, Yvonne Lim Yijuan, Cindy Ho Wei Li, Maria Güemes, Khalid Hussain
Hyperinsulinaemic hypoglycaemia (HH), which causes persistent neonatal hypoglycaemia, can result in neurological damage and it's management is challenging. Diazoxide is the first-line treatment, albeit not all patients will fully respond to it, as episodes of hypoglycaemia may persist and it entails unpleasant adverse effects. Sirolimus, an mTOR inhibitor, has reportedly been successful in treating children with severe diffuse HH, thus obviating the need for pancreatectomy. We report a girl with HH, with a novel heterozygous ABCC8 gene missense mutation (c...
2016: Endocrinology, Diabetes & Metabolism Case Reports
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