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Neonatal hypoglycaemia

Ana Margarida Monteiro, Olinda Marques, Sofia Martins, Ana Antunes
The authors report a case of a 15-year-old girl with hypopituitarism due to pituitary stalk interruption syndrome diagnosed in the neonatal period. The patient was admitted to the emergency room with impaired consciousness and hypoglycaemia. The day before, she increased her water intake to about 1.5 L to perform a pelvic ultrasound. In the following hours, she developed vomiting and food refusal. Blood analysis revealed hypoglycaemia, hyponatraemia, decreased serum osmolality and normal urinary density. Hyponatraemia and adrenal crisis were managed with a gradual but slow resolution of consciousness and electrolytic balance...
March 9, 2018: BMJ Case Reports
Rachel T McGrath, Sarah J Glastras, Emma S Scott, Samantha L Hocking, Gregory R Fulcher
Metformin is increasingly being used a therapeutic option for the management of gestational diabetes mellitus (GDM). The aim of this study was to compare the maternal characteristics and perinatal outcomes of women with GDM treated with metformin (with or without supplemental insulin) with those receiving other management approaches. A retrospective, case-control study was carried out and 83 women taking metformin were matched 1:1 with women receiving insulin or diet and lifestyle modification alone. Women managed with diet and lifestyle modification had a significantly lower fasting plasma glucose ( p < 0...
March 9, 2018: Journal of Clinical Medicine
Anna C Tottman, Frank H Bloomfield, Barbara E Cormack, Jane E Harding, M Atif Mohd Slim, Abigail F Weston, Jane M Alsweiler
OBJECTIVES: To determine whether changes to early nutrition are associated with levels of glycaemia in very preterm infants. METHODS: A retrospective, observational study of infants <1,500 grams or <30 weeks' gestation admitted to Neonatal Intensive Care, National Women's Hospital, NZ, before (Old Protocol) and after (New Protocol) a change in nutritional protocol. Nutritional intakes were calculated and averaged by day for postnatal days 1-7 (Week 1) and 1-28 (Month 1)...
February 23, 2018: Journal of Pediatric Gastroenterology and Nutrition
Aida Kalok, Pravin Peraba, Shamsul Azhar Shah, Zaleha Abdullah Mahdy, Mohamad Abdul Jamil, Nirmala Kampan, Suraya Sulaiman, Nor Azlin Mohamed Ismail
Background Gestational diabetes mellitus (GDM) is on the rise globally and there are various screening guidelines with regard to patients' criteria. Materials and methods We conducted a prospective cross-sectional study to determine the prevalence of GDM amongst low-risk pregnant women above the age of 25 years. A modified glucose tolerance test (MGTT) was performed between 24 and 36 weeks of gestation. Women with GDM were divided into two groups for analysis: age between 25 and 34 years (group A) and above 35 years (group B)...
February 9, 2018: Hormone Molecular Biology and Clinical Investigation
Soon Leong Yong, Beng Kwang Ng, Muhammad Abdul Jamil Mohd Yassin, Syed Zulkifli Syed Zakaria, Nor Azlin Mohamed Ismail
This study was to assess the relationship between late pregnancy haemoglobin A1C (HbA1C) at 29-30 weeks of gestation and adverse pregnancy outcomes (APOs) in 272 pregnant women with pre-existing diabetes. HbA1C ≥6.1% was associated with significantly increased risk of preterm delivery, Caesarean section, large for gestational age (LGA), neonatal respiratory distress, neonatal hypoglycaemia, and composite adverse neonatal outcome (p < .05). The risk of pre-eclampsia increased significantly at the lower HbA1C cut-off of > 5...
February 1, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Binesh Balachandran, Kanya Mukhopadhyay, Naresh Sachdeva, Rama Walia, Savita Verma Attri
AIM: Hyperinsulinaemic hypoglycaemia (HH) is a very common cause of hypoglycaemia in small for gestational age (SGA) neonates. We compared using early oral diazoxide or a placebo for this patient group. METHODS: This was a randomised, double-blind, placebo-controlled trial that focused on SGA neonates born at at least 32 weeks of gestation with HH during the first five days of life. Neonates with severe perinatal asphyxia, sepsis or contraindications for oral feeds were excluded...
January 31, 2018: Acta Paediatrica
Frédéric Brioude, Jennifer M Kalish, Alessandro Mussa, Alison C Foster, Jet Bliek, Giovanni Battista Ferrero, Susanne E Boonen, Trevor Cole, Robert Baker, Monica Bertoletti, Guido Cocchi, Carole Coze, Maurizio De Pellegrin, Khalid Hussain, Abdulla Ibrahim, Mark D Kilby, Malgorzata Krajewska-Walasek, Christian P Kratz, Edmund J Ladusans, Pablo Lapunzina, Yves Le Bouc, Saskia M Maas, Fiona Macdonald, Katrin Õunap, Licia Peruzzi, Sylvie Rossignol, Silvia Russo, Caroleen Shipster, Agata Skórka, Katrina Tatton-Brown, Jair Tenorio, Chiara Tortora, Karen Grønskov, Irène Netchine, Raoul C Hennekam, Dirk Prawitt, Zeynep Tümer, Thomas Eggermann, Deborah J G Mackay, Andrea Riccio, Eamonn R Maher
Beckwith-Wiedemann syndrome (BWS), a human genomic imprinting disorder, is characterized by phenotypic variability that might include overgrowth, macroglossia, abdominal wall defects, neonatal hypoglycaemia, lateralized overgrowth and predisposition to embryonal tumours. Delineation of the molecular defects within the imprinted 11p15.5 region can predict familial recurrence risks and the risk (and type) of embryonal tumour. Despite recent advances in knowledge, there is marked heterogeneity in clinical diagnostic criteria and care...
January 29, 2018: Nature Reviews. Endocrinology
Denice S Feig, Helen R Murphy
AIMS: To review the current literature on the use of continuous glucose monitoring during pregnancy in women with Type 1 diabetes. METHODS: We searched the literature for randomized controlled trials using continuous glucose monitoring during pregnancy in women with Type 1 diabetes. RESULTS: Three randomized trials were found and discussed in this review. One UK study found a reduction in large-for-gestational-age infants; however, only masked continuous glucose monitoring was used in that study...
January 20, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
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
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
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
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
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
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
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
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
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
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
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.)
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
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