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glucose management in neonates

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https://www.readbyqxmd.com/read/28409762/readmission-for-neonatal-hyperbilirubinemia-in-an-area-with-a-high-prevalence-of-glucose-6-phosphate-dehydrogenase-deficiency-a-hospital-based-retrospective-study
#1
A M Al-Omran, S Y Al-Abdi, Z S Al-Salam
BACKGROUND: Hyperbilirubinemia is one of the most common causes of neonatal readmission to hospital. AIMS: To assess risk factors for hyperbilirubinemia among neonates readmitted for this condition and the ratio of the mean corpuscular hemoglobin concentration (MCHC) to the mean corpuscular volume (MCV). METHODS: We retrospectively studied the clinical and laboratory findings, management and possible risk factors for hyperbilirubinemia in 301 neonates born at ≥35 weeks gestation and readmitted to hospital owing to hyperbilirubinemia over five years...
April 8, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28264826/computer-determined-dosage-of-insulin-in-the-management-of-neonatal-hyperglycaemia-hint2-protocol-of-a-randomised-controlled-trial
#2
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/28110175/ketogenic-diet-therapy-for-epilepsy-during-pregnancy-a-case-series
#3
Elles J T M van der Louw, Tanya J Williams, Bobbie J Henry-Barron, Joanne F Olieman, Johannes J Duvekot, Marijn J Vermeulen, Natalja Bannink, Monique Williams, Rinze F Neuteboom, Eric H Kossoff, Coriene E Catsman-Berrevoets, Mackenzie C Cervenka
PURPOSE: Evaluation of ketogenic diet (KD) therapies for seizure control during pregnancy when safety and appropriate management become considerations. Until now, no information has been available on seizure reduction and human pregnancy related outcomes in women treated with KD therapies. METHOD: We describe two cases of pregnant women with epilepsy treated with KD therapy either as monotherapy (Case 1) or as adjunctive therapy (Case 2). RESULTS: Case 1: A 27 year old woman, gravida1, started the classic KD with medium chain triglyceride (MCT) emulsion and 75g carbohydrate-restriction, later reduced to 47g...
February 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28026897/pregnancy-outcome-of-gestational-diabetes-mellitus-using-a-structured-model-of-care-wings-project-wings-10
#4
Ram Uma, Balaji Bhavadharini, Harish Ranjani, Manni Mohanraj Mahalakshmi, Ranjit Mohan Anjana, Ranjit Unnikrishnan, Arivudainambi Kayal, Belma Malanda, Anne Belton, Viswanathan Mohan
AIM: To evaluate the impact of a structured model of care (MOC) prepared for resource-constrained settings, on the pregnancy outcomes of Asian Indian women with gestational diabetes mellitus (GDM). METHODS: Pregnant women were screened under the Women in India with GDM Strategy (WINGS) MOC for GDM using the International Association of Diabetes and Pregnancy Study Groups criteria. Women with GDM went through a structured MOC that included medical nutrition therapy (MNT), regular physical activity (PA); and insulin when indicated...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27999970/oral-30-glucose-provides-sufficient-sedation-in-newborns-during-mri
#5
H Evren Eker, Oya Yalcin Cok, Bilin Çetinkaya, Anis Aribogan
PURPOSE: Newborns are often sedated during MRI but sedation itself creates adverse events and management is more challenging in this environment. Oral glucose/sucrose administration has been studied in newborns during painful procedures; however, its effectiveness in keeping newborns sleepy and motionlessness during painless procedures has not been demonstrated. The objective of this study was to describe effectiveness of oral 30% glucose administration by comparing with intravenous midazolam sedation for newborns during MRI...
December 20, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27995150/risk-factors-for-the-requirement-of-antenatal-insulin-treatment-in-gestational-diabetes-mellitus
#6
Mayu Watanabe, Akihiro Katayama, Hidetoshi Kagawa, Daisuke Ogawa, Jun Wada
Poor maternal glycemic control increases maternal and fetal risk for adverse outcomes, and strict management of gestational diabetes mellitus (GDM) is recommended to prevent neonatal and maternal complications. However, risk factors for the requirement of antenatal insulin treatment (AIT) are not well-investigated in the pregnant women with GDM. We enrolled 37 pregnant women with GDM and investigated the risk for AIT by comparing the patients with AIT (AIT group; n = 10) and without insulin therapy (Diet group; n = 27)...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27989586/an-emerging-evidence-base-for-the-management-of-neonatal-hypoglycaemia
#7
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/27981932/g6pd-deficiency-with-arnold-chiari-malformation
#8
Shilpi Verma, Pradeep Kumar Bhatia, Vandana Sharma, Priyanka Sethi, Yogendra Raj Singh
A neonate with glucose-6-phosphate dehydrogenase (G6PD) deficiency and Arnold-Chiari Malformation (ACM) type 2 underwent lumbar meningomyelocele (MMC) repair. Patients with G6PD deficiency are prone to develop haemolysis following any kind of oxidative stress and in ACM, there is a disturbed cranio-spinal pressure relationship. The neonate was managed under general anaesthesia with propofol for induction as well as for maintenance along with fentanyl and oxygen-nitrous mixture.
November 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27915035/hyperinsulinaemic-hypoglycaemia-in-children-and-adults
#9
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/27862529/implementation-of-dextrose-gel-in-the-management-of-neonatal-hypoglycaemia
#10
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
#11
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
https://www.readbyqxmd.com/read/27829574/telemedicine-technologies-for-diabetes-in-pregnancy-a-systematic-review-and-meta-analysis
#12
REVIEW
Wai-Kit Ming, Lucy H Mackillop, Andrew J Farmer, Lise Loerup, Katy Bartlett, Jonathan C Levy, Lionel Tarassenko, Carmelo Velardo, Yvonne Kenworthy, Jane E Hirst
BACKGROUND: Diabetes in pregnancy is a global problem. Technological innovations present exciting opportunities for novel approaches to improve clinical care delivery for gestational and other forms of diabetes in pregnancy. OBJECTIVE: To perform an updated and comprehensive systematic review and meta-analysis of the literature to determine whether telemedicine solutions offer any advantages compared with the standard care for women with diabetes in pregnancy. METHODS: The review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework...
November 9, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27817881/the-effect-of-early-feeding-on-initial-glucose-concentrations-in-term-newborns
#13
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/27802864/glucokinase-mutation-a-rare-cause-of-recurrent-hypoglycemia-in-adults-a-case-report-and-literature-review
#14
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/27752317/improving-the-diagnosis-of-neonatal-hypoglycemia-in-a-well-baby-nursery
#15
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/27741952/maternal-antecedents-of-adiposity-and-studying-the-transgenerational-role-of-hyperglycemia-and-insulin-maasthi-a-prospective-cohort-study-protocol-of-birth-cohort-at-bangalore-india
#16
Giridhara R Babu, Gvs Murthy, R Deepa, Yamuna, Prafulla, H Kiran Kumar, Maithili Karthik, Keerti Deshpande, Sara E Benjamin Neelon, D Prabhakaran, Anura Kurpad, Sanjay Kinra
BACKGROUND: India is experiencing an epidemic of obesity-hyperglycaemia, which coincides with child bearing age for women. The epidemic can be sustained and augmented through transgenerational transmission of adiposity and glucose intolerance in women. This presents an opportunity for exploring a clear strategy for the control of this epidemic in India. We conducted a study between November 2013 and May 2015 to inform the design of a large pregnancy cohort study. Based on the findings of this pilot, we developed the protocol for the proposed birth cohort of 5000 women, the recruitment for which will start in April 2016...
October 14, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27640990/management-of-labour-in-pregnancy-complicated-by-diabetes
#17
Sadiah Ahsan Pal, Mariam Iqbal Ali
Diabetes mellitus complicates <5% of all pregnancies in Pakistan, but is a major cause of perinatal morbidity and mortality, as well as maternal morbidity. Appropriate glycaemic control is not only important throughout pregnancy but is equally important during the intra-partum period. Increased blood glucose levels 4-6 hours prior to delivery increase the chances of hypoglycaemia in neonates. It is essential to optimize blood glucose levels during the intra-partum period as avoiding maternal hyperglycaemia will prevent foetal hyperglycaemia, and hence reduce the chances of neonatal hypoglycaemia and foetal acidaemia...
September 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27597988/could-metformin-manage-gestational-diabetes-mellitus-instead-of-insulin
#18
Hend S Saleh, Walid A Abdelsalam, Hala E Mowafy, Azza A Abd ElHameid
Gestational diabetes mellitus (GDM) complicates a significant number of pregnancies. Blood glucose control improves perinatal outcomes. Medical nutrition therapy is the foundation in management. Aim of This Study. To evaluate efficacy of metformin in comparison to insulin for managing GDM. Methods. In prospective randomized comparative study, 150 antenatal women whose pregnancies had been complicated by GDM and did not respond to diet alone were recruited from antenatal clinics at Obstetrics Department in Zagazig University Hospitals from November 2012 to December 2014...
2016: International Journal of Reproductive Medicine
https://www.readbyqxmd.com/read/27590938/glucose-monitoring-in-pregnancy-complicated-by-diabetes
#19
Aisha Sheikh, Abdul Jabbar
Diabetes in pregnancy is associated with adverse maternal and neonatal outcomes. Due to variations in insulin resistance throughout pregnancy there is a continuous need to implement Medical Nutrition Therapy (MNT), exercise and pharmacological treatments which have to be escalated. Self-monitoring of blood glucose (SMBG) is integral to the management of diabetes in pregnancy. Proper implementation of SMBG in pregnant women with diabetes requires patient education and understanding of its applications and limitations...
September 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27582145/glucose-monitoring-in-pregnancy-complicated-by-diabetes
#20
Aisha Sheikh, Abdul Jabbar
Diabetes in pregnancy is associated with adverse maternal and neonatal outcomes. Due to variations in insulin resistance throughout pregnancy there is a continuous need to implement Medical Nutrition Therapy (MNT), exercise and pharmacological treatments which have to be escalated. Self-monitoring of blood glucose (SMBG) is integral to the management of diabetes in pregnancy. Proper implementation of SMBG in pregnant women with diabetes requires patient education and understanding of its applications and limitations...
September 2016: JPMA. the Journal of the Pakistan Medical Association
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