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blood glucose management in neonates

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https://www.readbyqxmd.com/read/27862529/implementation-of-dextrose-gel-in-the-management-of-neonatal-hypoglycaemia
#1
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...
November 15, 2016: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/27829574/telemedicine-technologies-for-diabetes-in-pregnancy-a-systematic-review-and-meta-analysis
#2
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/27802864/glucokinase-mutation-a-rare-cause-of-recurrent-hypoglycemia-in-adults-a-case-report-and-literature-review
#3
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/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
#4
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
#5
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
#6
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
#7
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
#8
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/27557930/risk-factors-and-outcomes-of-fetal-macrosomia-in-a-tertiary-centre-in-tanzania-a-case-control-study
#9
Aisha Salim Said, Karim Premji Manji
BACKGROUND: Fetal macrosomia is defined as birth weight ≥4000 g. Several risk factors have been shown to be associated with fetal macrosomia. There has been an increased incidence of macrosomic babies delivered and the antecedent complications. This study assessed the risk factors, maternal and neonatal complications of fetal macrosomia in comparison with normal birth weight neonates. METHODS: A case-control study was conducted at the Muhimbili National Hospital (MNH) maternity and neonatal wards...
2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27490775/longitudinal-patterns-of-glycemic-control-and-blood-pressure-in-pregnant-women-with-type-1-diabetes-mellitus-phenotypes-from-functional-data-analysis
#10
Rhonda D Szczesniak, Dan Li, Leo L Duan, Mekibib Altaye, Menachem Miodovnik, Jane C Khoury
Objective To identify phenotypes of type 1 diabetes control and associations with maternal/neonatal characteristics based on blood pressure (BP), glucose, and insulin curves during gestation, using a novel functional data analysis approach that accounts for sparse longitudinal patterns of medical monitoring during pregnancy. Methods We performed a retrospective longitudinal cohort study of women with type 1 diabetes whose BP, glucose, and insulin requirements were monitored throughout gestation as part of a program-project grant...
November 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27442401/neonatal-hypoglycemia-a-continuing-debate-in-definition-and-management
#11
REVIEW
Orhideja Stomnaroska-Damcevski, Elizabeta Petkovska, Snezana Jancevska, Dragan Danilovski
Neonatal hypoglycemia (NH) is one of the most common abnormalities encountered in the newborn. Maintaining glucose homeostasis is one of the important physiological events during fetal-to-neonatal transition. Transient low blood glucose concentrations are frequently encountered in the majority of healthy newborns and are the reflections of normal metabolic adaptation processes. Nevertheless, there is a great concern that prolonged or recurrent low blood glucose levels may result in long-term neurological and developmental consequences...
2015: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/27427266/obstetrical-correlates-and-perinatal-consequences-of-neonatal-hypoglycemia-in-term-infants
#12
D Ogunyemi, P Friedman, K Betcher, A Whitten, N Sugiyama, L Qu, Amitai Kohn, Paul Holtrop
OBJECTIVE: To determine independent perinatal and intrapartum factors associated with neonatal hypoglycemia Method: Of singleton pregnancies delivered at term in 2013; 318 (3.8%) neonates diagnosed with hypoglycemia were compared to 7955 (96.2%) neonate controls with regression analysis Results: Regression analysis showed that independent prenatal factors were multiparity (odds-ratio [OR] =1.61), gestational age (OR = 0.68), gestational diabetes (OR = 0.22), macrosomia (OR = 4...
July 17, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27371343/neonatal-outcomes-according-to-different-therapies-for-gestational-diabetes-mellitus
#13
Amanda L da Silva, Augusto R do Amaral, Daniela S de Oliveira, Lisiane Martins, Mariana R E Silva, Jean Carl Silva
OBJECTIVES: To compare different neonatal outcomes according to the different types of treatments used in the management of gestational diabetes mellitus (GDM). METHODS: This was a retrospective cohort study. The study population comprised pregnant women with GDM treated at a public maternity hospital from July 2010 to August 2014. The study included women aged at least 18 years, with a singleton pregnancy, who met the criteria for GDM. Blood glucose levels, fetal abdominal circumference, body mass index and gestational age were considered for treatment decision-making...
June 28, 2016: Jornal de Pediatria
https://www.readbyqxmd.com/read/27168942/new-approaches-to-management-of-neonatal-hypoglycemia
#14
REVIEW
Paul J Rozance, William W Hay
Despite being a very common problem after birth, consensus on how to manage low glucose concentrations in the first 48 h of life has been difficult to establish and remains a debated issue. One of the reasons for this is that few studies have provided the type of data needed to establish a definitive approach agreed upon by all. However, some recent publications have provided much needed primary data to inform this debate. These publications have focused on aspects of managing low blood glucose concentrations in the patients most at-risk for asymptomatic hypoglycemia-those born late-preterm, large for gestational age, small for gestational age, or growth restricted, and those born following a pregnancy complicated by diabetes mellitus...
2016: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/27142842/oral-dextrose-gel-for-the-treatment-of-hypoglycaemia-in-newborn-infants
#15
REVIEW
Philip J Weston, Deborah L Harris, Malcolm Battin, Julie Brown, Joanne E Hegarty, Jane E Harding
BACKGROUND: Neonatal hypoglycaemia, a common condition, can be associated with brain injury. It is frequently managed by providing infants with an alternative source of glucose, given enterally with formula or intravenously with dextrose solution. This often requires that mother and baby are cared for in separate environments and may inhibit breast feeding. Dextrose gel is simple and inexpensive and can be administered directly to the buccal mucosa for rapid correction of hypoglycaemia, in association with continued breast feeding and maternal care...
May 4, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27052232/-gestational-diabetes-mellitus
#16
Alexandra Kautzky-Willer, Jürgen Harreiter, Dagmar Bancher-Todesca, Angelika Berger, Andreas Repa, Monika Lechleitner, Raimund Weitgasser
Gestational diabetes (GDM) is defined as any degree of glucose intolerance with onset during pregnancy and is associated with increased feto-maternal morbidity as well as long-term complications in mothers and offspring. Women detected to have diabetes early in pregnancy receive the diagnosis of overt, non-gestational, diabetes (glucose: fasting > 126 mg/dl, spontaneous > 200 mg/dl or HbA1c > 6.5 % before 20 weeks of gestation). GDM is diagnosed by an oral glucose tolerance test (OGTT) or fasting glucose concentrations (> 92 mg/dl)...
April 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27023793/high-glucose-intake-and-glycaemic-level-in-critically-ill-neonates-with-inherited-metabolic-disorders-of-intoxication
#17
Marion Grimaud, Pascale de Lonlay, Laurent Dupic, Jean-Baptiste Arnoux, Anais Brassier, Philippe Hubert, Fabrice Lesage, Mehdi Oualha
UNLABELLED: To investigate glycaemic levels in critically ill neonates with inherited metabolic disorders of intoxication. Thirty-nine neonates with a median age of 7 days (0-24) were retrospectively included (urea cycle disorders (n = 18), maple syrup disease (n = 13), organic acidemias (n = 8)). Twenty-seven neonates were intubated, 21 were haemodialysed and 6 died. During the first 3 days, median total and peak blood glucose (BG) levels were 7.1 mmol/L (0.9-50) and 10 mmol/L (5...
June 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/26988348/trial-protocol-to-compare-the-efficacy-of-a-smartphone-based-blood-glucose-management-system-with-standard-clinic-care-in-the-gestational-diabetic-population
#18
Lucy H Mackillop, Katy Bartlett, Jacqueline Birks, Andrew J Farmer, Oliver J Gibson, Dev A Kevat, Yvonne Kenworthy, Jonathan C Levy, Lise Loerup, Lionel Tarassenko, Carmelo Velardo, Jane E Hirst
INTRODUCTION: The prevalence of gestational diabetes mellitus (GDM) is rising in the UK. Good glycaemic control improves maternal and neonatal outcomes. Frequent clinical review of patients with GDM by healthcare professionals is required owing to the rapidly changing physiology of pregnancy and its unpredictable course. Novel technologies that allow home blood glucose (BG) monitoring with results transmitted in real time to a healthcare professional have the potential to deliver good-quality healthcare to women more conveniently and at a lower cost to the patient and the healthcare provider compared to the conventional face-to-face or telephone-based consultation...
2016: BMJ Open
https://www.readbyqxmd.com/read/26978208/genetic-evidence-for-causal-relationships-between-maternal-obesity-related-traits-and-birth-weight
#19
Jessica Tyrrell, Rebecca C Richmond, Tom M Palmer, Bjarke Feenstra, Janani Rangarajan, Sarah Metrustry, Alana Cavadino, Lavinia Paternoster, Loren L Armstrong, N Maneka G De Silva, Andrew R Wood, Momoko Horikoshi, Frank Geller, Ronny Myhre, Jonathan P Bradfield, Eskil Kreiner-Møller, Ville Huikari, Jodie N Painter, Jouke-Jan Hottenga, Catherine Allard, Diane J Berry, Luigi Bouchard, Shikta Das, David M Evans, Hakon Hakonarson, M Geoffrey Hayes, Jani Heikkinen, Albert Hofman, Bridget Knight, Penelope A Lind, Mark I McCarthy, George McMahon, Sarah E Medland, Mads Melbye, Andrew P Morris, Michael Nodzenski, Christoph Reichetzeder, Susan M Ring, Sylvain Sebert, Verena Sengpiel, Thorkild I A Sørensen, Gonneke Willemsen, Eco J C de Geus, Nicholas G Martin, Tim D Spector, Christine Power, Marjo-Riitta Järvelin, Hans Bisgaard, Struan F A Grant, Ellen A Nohr, Vincent W Jaddoe, Bo Jacobsson, Jeffrey C Murray, Berthold Hocher, Andrew T Hattersley, Denise M Scholtens, George Davey Smith, Marie-France Hivert, Janine F Felix, Elina Hyppönen, William L Lowe, Timothy M Frayling, Debbie A Lawlor, Rachel M Freathy
IMPORTANCE: Neonates born to overweight or obese women are larger and at higher risk of birth complications. Many maternal obesity-related traits are observationally associated with birth weight, but the causal nature of these associations is uncertain. OBJECTIVE: To test for genetic evidence of causal associations of maternal body mass index (BMI) and related traits with birth weight. DESIGN, SETTING, AND PARTICIPANTS: Mendelian randomization to test whether maternal BMI and obesity-related traits are potentially causally related to offspring birth weight...
March 15, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26910320/high-mortality-risk-in-hypoglycemic-and-dysglycemic-children-admitted-at-a-referral-hospital-in-a-non-malaria-tropical-setting-of-a-low-income-country
#20
Hubert Barennes, Eng Sayavong, Eric Pussard
INTRODUCTION: Hypoglycemia is a recognized feature of severe malaria but its diagnosis and management remain problematic in resource-limited settings. There is limited data on the burden and prognosis associated with glycemia dysregulation in non-neonate children in non-malaria areas. We prospectively assessed the abnormal blood glucose prevalence and the outcome and risk factors of deaths in critically ill children admitted to a national referral hospital in Laos. METHODS: Consecutive children (1 month-15 years) admitted to the pediatric ward of Mahosot hospital, were categorized using the integrated management of childhood illness (IMCI)...
2016: PloS One
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