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blood glucose management in neonates

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https://www.readbyqxmd.com/read/29750952/glucostabilizer%C3%A2-software-guided-insulin-dosing-improves-intrapartum-glycemic-management-in-women-with-diabetes
#1
Cheryl Dinglas, Jolene Muscat, Tracy Adams, Virginia Peragallo-Dittko, Anthony Vintzileos, Hye J Heo
BACKGROUND: During labor, maintenance of maternal euglycemia is critical to decrease the risk of neonatal hypoglycemia and associated morbidities. When continuous intravenous insulin infusion is needed, standardized insulin dosing charts have been used for titration of insulin to maintain glucose in target range. GlucoStabilizer™ is a software-guided insulin dosing system that calculates the dose of intravenous insulin needed based on metabolic parameters, target glucose concentration, and an individual's response to insulin...
May 8, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29710737/cerebral-glucose-deficiency-versus-oxygen-deficiency-in-neonatal-encephalopathy
#2
A M Rudolph
Hypoxic-ischemic encephalopathy (HIE) in newborn infants is generally considered to result from decreased arterial oxygen content or cerebral blood flow. Cerebral injury similar to that of HIE has been noted with hypoglycemia. Studies in fetal lambs have shown that ventilation with 3% oxygen did not change cerebral blood flow, but ventilation with 100% oxygen resulted in marked reduction in cerebral blood flow, glucose delivery and glucose consumption. Blood glucose concentration falls markedly after birth; this, associated with the fall in cerebral blood flow, greatly reduces glucose supply to the brain...
April 24, 2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29709964/bacterial-culture-negative-subclinical-intra-amniotic-infection-can-be-detected-by-bacterial-16s-ribosomal-dna-amplifying-polymerase-chain-reaction
#3
Sachi Morimoto, Hirokazu Usui, Tatsuya Kobayashi, Eiji Katou, Shunji Goto, Hirokazu Tanaka, Makio Shozu
Comprehensive analysis of bacterial DNA enhanced our understanding of the maternal microbiome and its disturbance in preterm birth, although clinical utility of these techniques remains to be determined. We examined whether broad-range polymerase technique is useful for detection of culture-negative intra-amniotic infection (IAI). Pregnant women who underwent amniocentesis for the management of preterm birth with or without the premature rupture of membranes. Bacterial 16S ribosomal DNA in the amniotic fluid was detected by polymerase chain reaction (PCR) using primers for a sequence shared by Ureaplasma, Mycoplasma, and other bacteria...
April 27, 2018: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29707034/laser-acupuncture-at-large-intestine-4-compared-with-oral-glucose-administration-for-pain-prevention-in-healthy-term-neonates-undergoing-routine-heel-lance-study-protocol-for-an-observer-blinded-randomised-controlled-clinical-trial
#4
Jasmin Stadler, Alexander Avian, Katrin Posch, Berndt Urlesberger, Wolfgang Raith
Background: Nonpharmacological strategies have actually become more important in neonatal pain management during routinely applied minor painful procedures. However, commonly used nonpharmacological strategies are inferior to orally administered sweet solutions. Therefore, we will compare laser acupuncture, as a recent nonpharmacological method, with the standard care of oral glucose solution for pain prevention. Methods: Ninety-five healthy term neonates will be allocated into one of two groups...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/29692380/unsatisfactory-glucose-management-and-adverse-pregnancy-outcomes-of-gestational-diabetes-mellitus-in-the-real-world-of-clinical-practice-a-retrospective-study
#5
Ru Feng, Lu Liu, Yuan-Yuan Zhang, Zhong-Shang Yuan, Ling Gao, Chang-Ting Zuo
Background: Facing the increasing prevalence of gestational diabetes mellitus (GDM), this study aimed to evaluate the management of GDM and its association with adverse pregnancy outcomes. Methods: The data of 996 inpatients with GDM who terminated pregnancies in our hospital from January 2011 to December 2015 were collected. Treatments during pregnancy and the last hospital admission before delivery were analyzed. Pregnancy outcomes of the GDM patients were compared with 996 nondiabetic subjects matched by delivery year and gestational age...
May 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29559428/comparing-the-efficacy-of-a-mobile-phone-based-blood-glucose-management-system-with-standard-clinic-care-in-women-with-gestational-diabetes-randomized-controlled-trial
#6
Lucy Mackillop, Jane Elizabeth Hirst, Katy Jane Bartlett, Jacqueline Susan Birks, Lei Clifton, Andrew J Farmer, Oliver Gibson, Yvonne Kenworthy, Jonathan Cummings Levy, Lise Loerup, Oliver Rivero-Arias, Wai-Kit Ming, Carmelo Velardo, Lionel Tarassenko
BACKGROUND: Treatment of hyperglycemia in women with gestational diabetes mellitus (GDM) is associated with improved maternal and neonatal outcomes and requires intensive clinical input. This is currently achieved by hospital clinic attendance every 2 to 4 weeks with limited opportunity for intervention between these visits. OBJECTIVE: We conducted a randomized controlled trial to determine whether the use of a mobile phone-based real-time blood glucose management system to manage women with GDM remotely was as effective in controlling blood glucose as standard care through clinic attendance...
March 20, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29540199/cerebrospinal-fluid-protein-and-glucose-levels-in-neonates-with-a-systemic-inflammatory-response-without-meningitis
#7
Mona Noureldein, Roxana Mardare, Jack Pickard, Hoi Lun Shing, Michael Eisenhut
BACKGROUND: It has been estimated that paediatric meningitis without elevated CSF white cell count (pleocytosis) accounts for 0.5-12% of all cases of bacterial meningitis. CSF protein and glucose measurements are therefore essential in management but may be neglected in clinical practice. In order to improve recognition of bacterial meningitis in neonates and to enable adequate management and audit, we investigated whether a systemic inflammatory response in the absence of meningitis is associated with elevated CSF protein and reduced CSF glucose levels...
March 14, 2018: Fluids and Barriers of the CNS
https://www.readbyqxmd.com/read/29534258/management-of-diabetes-in-the-intrapartum-and-postpartum-patient
#8
Annie Dude, Charlotte M Niznik, Emily D Szmuilowicz, Alan M Peaceman, Lynn M Yee
Achieving maternal euglycemia in women with pregestational and gestational diabetes mellitus is critical to decreasing the risk of neonatal hypoglycemia, as maternal blood glucose levels around the time of delivery are directly related to the risk of hypoglycemia in the neonate. Many institutions use continuous insulin and glucose infusions during the intrapartum period, although practices are widely variable. At Northwestern Memorial Hospital, the "Management of the Perinatal Patient with Diabetes" policy and protocol was developed to improve consistency of management while also allowing individualization appropriate for the patient's specific diabetic needs...
March 13, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29437908/a-quality-improvement-initiative-to-reduce-nicu-transfers-for-neonates-at-risk-for-hypoglycemia
#9
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/29346140/neonatal-hypoglycemia-continuous-glucose-monitoring
#10
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...
April 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29331007/anaesthetic-management-of-nesidioblastosis-in-two-infants
#11
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/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/28943514/a-novel-kcnj11-mutation-associated-with-transient-neonatal-diabetes
#13
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/28650702/a-case-report-of-methadone-associated-hypoglycemia-in-an-11-month-old-male
#14
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...
January 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/28642988/development-of-pulmonary-hypertension-during-treatment-with-diazoxide-a-case-series-and-literature-review
#15
REVIEW
Matthew R Timlin, Alexander B Black, Heather M Delaney, Renée I Matos, Candace S Percival
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy. The mainstay of medical management for CHI is diazoxide. Diazoxide inhibits insulin release from the pancreas, but also causes smooth muscle relaxation and fluid retention so it is typically given with chlorothiazide. In July 2015, the FDA issued a drug safety communication warning that pulmonary hypertension (PH) had been reported in 11 infants being treated with diazoxide and that the PH resolved with withdrawal of diazoxide...
August 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28622787/monitoring-of-the-newborn-dog-and-prediction-of-neonatal-mortality
#16
Hanna Mila, Aurélien Grellet, Marine Delebarre, Claire Mariani, Alexandre Feugier, Sylvie Chastant-Maillard
Despite the high neonatal mortality rate in puppies, pertinent criteria for health evaluation of the newborns are not defined. This study was thus designed to measure and to characterize factors of variation of six health parameters in dog neonates, and to evaluate their value as predictors of neonatal mortality. A total of 347 purebred puppies under identical conditions of housing and management were examined within the first 8h after birth and then at Day 1. The first health evaluation included Apgar score, weight, blood glucose, lactate and β-hydroxybutyrate concentration, rectal temperature and urine specific gravity (SG)...
August 1, 2017: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/28602020/techniques-of-monitoring-blood-glucose-during-pregnancy-for-women-with-pre-existing-diabetes
#17
REVIEW
Foong Ming Moy, Amita Ray, Brian S Buckley, Helen M West
BACKGROUND: Self-monitoring of blood glucose (SMBG) is recommended as a key component of the management plan for diabetes therapy during pregnancy. No existing systematic reviews consider the benefits/effectiveness of various techniques of blood glucose monitoring on maternal and infant outcomes among pregnant women with pre-existing diabetes. The effectiveness of the various monitoring techniques is unclear. OBJECTIVES: To compare techniques of blood glucose monitoring and their impact on maternal and infant outcomes among pregnant women with pre-existing diabetes...
June 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28535836/season-of-birth-is-associated-with-first-lactation-milk-yield-in-holstein-friesian-cattle
#18
M Van Eetvelde, M M Kamal, L Vandaele, G Opsomer
The aim of the present research was to assess factors associated with first-lactation milk yield in dairy heifers, including maternal and environmental factors, factors related to the development of the heifer and factors related to its offspring such as gender of the calf. In addition, the potential underlying mechanism, in particular metabolic adaptations, was further explored. Data on body growth, reproduction and milk yield of 74 Holstein Friesian heifers on three herds in Flanders (Belgium) were collected...
May 24, 2017: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/28527303/insulin-therapy-in-neonatal-diabetes-mellitus-a-review-of-the-literature
#19
REVIEW
Ivana Rabbone, Fabrizio Barbetti, Raffaella Gentilella, Gilberto Mossetto, Riccardo Bonfanti, Claudio Maffeis, Dario Iafusco, Elvira Piccinno
AIMS: Neonatal diabetes mellitus (NDM) is a rare disorder, and guidance is limited regarding its optimal management. We reviewed insulin usage in NDM, with a focus on continuous subcutaneous insulin infusion (CSII). METHODS: A PubMed search identified 40 reports of patients with NDM treated with insulin published between 1994 and 2016. RESULTS: Data concerning treatment of NDM are limited. CSII resolves some of the issues associated with insulin therapy in neonates...
July 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28461823/neonatal-indirect-hyperbilirubinemia-and-glucose-6-phosphate-dehydrogenase-deficiency
#20
Hasan M Isa, Masooma S Mohamed, Afaf M Mohamed, Adel Abdulla, Fuad Abdulla
PURPOSE: This study aimed to determine the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants with neonatal indirect hyperbilirubinemia (NIH); compare G6PD-deficient and G6PD-normal patients regarding hyperbilirubinemia and need for exchange transfusions (ET); and assess risk factors for ET and kernicterus. METHODS: This is a case-control retrospective study. Medical records of NIH patients admitted to the Pediatric Department, Salmaniya Medical Complex, Bahrain, between January 2007 and June 2010 were reviewed...
April 2017: Korean Journal of Pediatrics
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