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glucose management in neonates

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https://www.readbyqxmd.com/read/29437908/a-quality-improvement-initiative-to-reduce-nicu-transfers-for-neonates-at-risk-for-hypoglycemia
#1
Sherry LeBlanc, Jamie Haushalter, Carl Seashore, Karen S Wood, Michael J Steiner, Ashley G Sutton
BACKGROUND AND OBJECTIVE: Neonatal hypoglycemia is a common problem, often requiring management in the NICU. Nonpharmacologic interventions, including early breastfeeding and skin-to-skin care (SSC), may prevent hypoglycemia and the need to escalate care. Our objective was to maintain mother-infant dyads in the mother-infant unit by decreasing hypoglycemia resulting in NICU transfer. METHODS: Inborn infants ≥35 weeks' gestation with at least 1 risk factor for hypoglycemia were included...
February 8, 2018: Pediatrics
https://www.readbyqxmd.com/read/29425107/screening-for-gestational-diabetes-in-low-risk-women-effect-of-maternal-age
#2
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
https://www.readbyqxmd.com/read/29356579/insulin-treatment-cannot-promote-lipogenesis-in-rat-fetal-lung-in-gestational-diabetes-mellitus-because-of-failure-to-redress-the-imbalance-among-srebp-1-scap-and-insig-1
#3
Jinyan Li, Guanhua Qian, Xiaocui Zhong, Tinghe Yu
Gestational diabetes mellitus (GDM) has a higher incidence of neonatal respiratory distress syndrome, and lipogenesis is required for the synthesis of pulmonary surfactants. The aim of this study was to determine the effect of insulin treatment in GDM on the production of lipids in the lungs of fetal rats. GDM was induced by streptozotocin, and insulin was used to manage diabetes. Type II alveolar epithelial cells (AEC II), bronchoalveolar lavage fluid (BALF), and lung tissues of the neonatal rats were sampled for analyses...
January 22, 2018: DNA and Cell Biology
https://www.readbyqxmd.com/read/29346140/neonatal-hypoglycemia-continuous-glucose-monitoring
#4
Rajesh Shah, Christopher J D McKinlay, Jane E Harding
PURPOSE OF REVIEW: Continuous glucose monitoring (CGM) is increasingly used in the management of diabetes in children and adults, but there are few data regarding its use in neonates. The purpose of this article is to discuss the potential benefits and limitations of CGM in neonates. RECENT FINDINGS: Smaller electrodes in new sensors and real-time monitoring have made CGM devices more approachable for neonatal care. CGM is well tolerated in infants including very low birth weight babies, and few if any local complications have been reported...
January 17, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29331007/anaesthetic-management-of-nesidioblastosis-in-two-infants
#5
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/29280746/congenital-hyperinsulinism-diagnosis-and-treatment-update
#6
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/29211784/urinary-metabolomic-analysis-to-identify-preterm-neonates-exposed-to-histological-chorioamnionitis-a-pilot-study
#7
Claudia Fattuoni, Carlo Pietrasanta, Lorenza Pugni, Andrea Ronchi, Francesco Palmas, Luigi Barberini, Angelica Dessì, Roberta Pintus, Vassilios Fanos, Antonio Noto, Fabio Mosca
OBJECTIVE: Chorioamnionitis is a leading cause of preterm birth worldwide, with higher incidence at lower gestational ages. An early and reliable diagnosis of histological chorioamnionitis (HCA) in preterm infants may be helpful in guiding postnatal management, especially the administration of prophylactic antibiotics to prevent early-onset sepsis. The main aim of this study was to investigate metabolomic analysis of urines collected in the first 24 hours of life as diagnostic tool of HCA...
2017: PloS One
https://www.readbyqxmd.com/read/29184814/hypoglycemia-in-the-preterm-neonate-etiopathogenesis-diagnosis-management-and-long-term-outcomes
#8
REVIEW
Anudeepa Sharma, Ajuah Davis, Prem S Shekhawat
Glucose, like oxygen, is of fundamental importance for any living being and it is the major energy source for the fetus and the neonate during gestation. The placenta ensures a steady supply of glucose to the fetus, while birth marks a sudden change in substrate delivery and a major change in metabolism. Hypoglycemia is one of the most common pathologies encountered in the neonatal intensive care unit and affects a wide range of neonates. Preterm, small for gestational age (GA) and intra-uterine growth restricted neonates are especially vulnerable due to their lack of metabolic reserves and associated co-morbidities...
October 2017: Translational pediatrics
https://www.readbyqxmd.com/read/29180294/homeopathic-treatment-as-an-alternative-prophylactic-to-minimize-bacterial-infection-and-prevent-neonatal-diarrhea-in-calves
#9
Bruno F Fortuoso, Andreia Volpato, Luana Rampazzo, Patrícia Glombowsky, Luiz Gustavo Griss, Gabriela M Galli, Lenita M Stefani, Matheus D Baldissera, Emanuel B Ferreira, Gustavo Machado, Aleksandro S da Silva
Bovine neonatal diarrhea is common due low immunity in newborn calves, poor management (or absence) of sanitary barriers, and other factors. Newborn calves with diarrhea in the first days of life suffer failure to thrive and may die if left untreated. The aim of this study was to evaluate whether prophylactic administration of a homeopathic product (Dia 100®) can control bovine neonatal diarrhea in calves born on a farm with substantial sanitary challenges. We counted total bacteria and protozoan parasites in fecal samples...
November 24, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29167927/new-diagnostic-criteria-for-gestational-diabetes-mellitus-and-their-impact-on-the-number-of-diagnoses-and-pregnancy-outcomes
#10
Sarah H Koning, Jelmer J van Zanden, Klaas Hoogenberg, Helen L Lutgers, Alberdina W Klomp, Fleurisca J Korteweg, Aren J van Loon, Bruce H R Wolffenbuttel, Paul P van den Berg
AIMS/HYPOTHESIS: Detection and management of gestational diabetes mellitus (GDM) are crucial to reduce the risk of pregnancy-related complications for both mother and child. In 2013, the WHO adopted new diagnostic criteria for GDM to improve pregnancy outcomes. However, the evidence supporting these criteria is limited. Consequently, these new criteria have not yet been endorsed in the Netherlands. The aim of this study was to determine the impact of these criteria on the number of GDM diagnoses and pregnancy outcomes...
November 22, 2017: Diabetologia
https://www.readbyqxmd.com/read/29082022/systematic-review-of-the-clinical-manifestations-of-glucose-6-phosphate-dehydrogenase-deficiency-in-the-greater-mekong-subregion-implications-for-malaria-elimination-and-beyond
#11
Ken Ing Cherng Ong, Hodaka Kosugi, Sophea Thoeun, Hitomi Araki, Moe Moe Thandar, Moritoshi Iwagami, Bouasy Hongvanthong, Paul T Brey, Shigeyuki Kano, Masamine Jimba
INTRODUCTION: To achieve malaria elimination in the Greater Mekong Subregion (GMS) by 2030, proper case management is necessary. 8-aminoquinolines, such as primaquine, are the only available medicines effective in preventing relapse of the hypnozoite stage of Plasmodium vivax, as well as the onward transmission of Plasmodium falciparum. However, primaquine can cause haemolysis in individuals who have glucose-6-phosphate dehydrogenase deficiency (G6PDd). We conducted a systematic review on the reported clinical manifestations of G6PDd to provide a comprehensive overview of the situation in the GMS...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29051825/continuous-glucose-monitoring-in-neonates-a-review
#12
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
#13
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/28964639/early-continuous-renal-replacement-therapy-improves-nutrition-delivery-in-neonates-during-extracorporeal-life-support
#14
Heidi J Murphy, John B Cahill, Katherine E Twombley, James R Kiger
OBJECTIVE: Optimizing nutrition in neonatal patients as soon as possible after extracorporeal life support (ECLS) initiation is imperative as malnutrition can worsen both short- and long-term outcomes. Fluid restriction, used to manage the fluid overload that commonly complicates neonatal ECLS, severely impairs nutrition delivery. Continuous renal replacement therapy (CRRT) can be used to help manage fluid overload. We hypothesize that early CRRT utilization ameliorates the need for fluid restriction and allows providers to prescribe higher parenteral nutrition (PN) volumes leading to better nutrition delivery...
January 2018: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28943514/a-novel-kcnj11-mutation-associated-with-transient-neonatal-diabetes
#15
Evangelia Gole, Stavroula Oikonomou, Sian Ellard, Elisa De Franco, Kyriaki Karavanaki
BACKGROUND: Neonatal diabetes mellitus (NDM) is a rare type of monogenic diabetes that presents in the first 6 months of life. Activating mutations in the KCNJ11 gene encoding for the Kir6.2 subunit of the KATP channel can lead to transient (TNDM) or permanent neonatal diabetes mellitus (PNDM). CASE REPORT: A female infant presented at the 22nd day of life with severe hyperglycemia and ketoacidosis (glucose: 907mg/dl, blood gas pH: 6.84, HCO3: 6mmol/l). She was initially managed with intravenous (IV) fluids and IV insulin...
September 25, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28930827/comparative-efficacy-and-safety-of-oral-antidiabetic-drugs-and-insulin-in-treating-gestational-diabetes-mellitus-an-updated-prisma-compliant-network-meta-analysis
#16
Hui-Ling Liang, Shu-Juan Ma, Yan-Ni Xiao, Hong-Zhuan Tan
BACKGROUND: The safety and efficacy of different drugs in treatment of gestational diabetes mellitus (GDM) patients who could not maintain normal glucose level only through diet and exercise remains to be debated. We performed this network meta-analysis (NAM) to compare and rank different antidiabetic drugs in glucose level control and pregnancy outcomes in GDM patients. METHODS: We searched PubMed, Cochrane Library, Web of Science, and Embase up to December 31, 2016...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28855921/diagnosis-and-treatment-of-hyperinsulinaemic-hypoglycaemia-and-its-implications-for-paediatric-endocrinology
#17
REVIEW
Huseyin Demirbilek, Sofia A Rahman, Gonul Gulal Buyukyilmaz, Khalid Hussain
Glucose homeostasis requires appropriate and synchronous coordination of metabolic events and hormonal activities to keep plasma glucose concentrations in a narrow range of 3.5-5.5 mmol/L. Insulin, the only glucose lowering hormone secreted from pancreatic β-cells, plays the key role in glucose homeostasis. Insulin release from pancreatic β-cells is mainly regulated by intracellular ATP-generating metabolic pathways. Hyperinsulinaemic hypoglycaemia (HH), the most common cause of severe and persistent hypoglycaemia in neonates and children, is the inappropriate secretion of insulin which occurs despite low plasma glucose levels leading to severe and persistent hypoketotic hypoglycaemia...
2017: International Journal of Pediatric Endocrinology
https://www.readbyqxmd.com/read/28832100/consensus-on-use-of-insulins-in-gestational-diabetes
#18
Kalyan Kumar Gangopadhyay, J J Mukherjee, R K Sahay
INTRODUCTION: Gestational Diabetes Mellitus (GDM), diabetes diagnosed during pregnancy is associated with maternal (caesarean delivery, hypoglycaemia, hyperbilirubinaemia, shoulder dystocia, pre-term delivery and birth trauma) and fetal (Hyperbilirubinaemia in offspring, Neonatal hypoglycaemia, Macrosomia) complications. Despite, insulin being the standard treatment for GDM cases, there is no existing comprehensive consensus update on use of insulin in Indian patients with GDM. OBJECTIVE: To provide simple and easily implementable guidelines to healthcare physicians on use of insulin in GDM...
March 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28660389/clinical-and-molecular-characterization-of-prader-willi-syndrome
#19
G N Sanjeeva, Madhuri Maganthi, Himabindu Kodishala, Rohit Kumar R Marol, Pooja S Kulshreshtha, Elisa Lorenzetto, Jayarama S Kadandale, Uros Hladnik, P Raghupathy, Meenakshi Bhat
OBJECTIVES: To describe the clinical presentations and molecular diagnosis to aid the clinicians in early diagnosis and appropriate management of Prader-Willi syndrome (PWS). METHODS: Thirty-four clinically diagnosed PWS cases were enrolled after obtaining informed consent/assent. Demographic details, clinical data and anthropometry were recorded using structured proforma. The facial dysmorphology was evaluated. Appropriate genetic testing was performed to confirm the diagnosis...
November 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28650702/a-case-report-of-methadone-associated-hypoglycemia-in-an-11-month-old-male
#20
Michael S Toce, Margaret A Stefater, David T Breault, Michele M Burns
BACKGROUND: Methadone is a synthetic μ-opioid receptor agonist that is used in the management of pain, neonatal abstinence withdrawal syndrome, and opioid dependence. Overdose can cause miosis, respiratory depression, and central nervous system depression. Rarely, hypoglycemia has been reported. We present the case of an 11-month-old male who developed hypoketotic, hyperinsulinemic, hypoglycemia after an acute, unintentional methadone exposure. CASE DETAILS: The patient was a previously healthy 11-month-old male who presented in respiratory failure...
June 26, 2017: Clinical Toxicology
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