Persistent Hypoglycemia, a Rare and Underestimated Finding Narrative Review of the Literature
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Feb 5, 2023
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Abstract
Persistent hypoglycemia is a metabolic disorder characterized by the inability to self-regulate serum glycemia after 72 hours of life secondary to a wide range of pathologies, among which are metabolic alterations secondary to maternal pathologies such as intrauterine growth restriction, inborn errors of metabolism such as glycogen storage disorders and beta oxidation disorders, and problems in counterregulatory hormones such as growth hormone deficiency. Its diagnosis denotes a challenge because sometimes patients do not present clinical manifestations or these are nonspecific. The critical sample, a set of serum laboratory tests taken in the period of hypoglycemia, allows rapid identification of the most common causative pathologies that require some specific treatment. A narrative review of the most common pathologies associated with persistent hypoglycemia and the usefulness of the critical sample in its diagnosis is carried out.
Keywords
Hipoglicemia, Errores innatos del Metabolismo, neonato, recien nacido, hiperinsulinismo congenitohypoglycemia, congenital hyperinsulinemia, inborn errors of metabolism, neonate
References
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19. Puchalski ML, Russell TL, Karlsen KA. Neonatal hypoglycemia: is there a sweet spot? Crit Care Nurs Clin North Am [internet]. 2018 dic [citado 2022 may 1];30(4):467-80. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/30447807
20. McKinlay CJD, Alsweiler JM, Anstice NS, Burakevych N, Chakraborty A, Chase JG, et al. Association of neonatal glycemia with neurodevelopmental outcomes at 4.5 years. JAMA Pediatr. 2017;171(10):972-83. https://doi.org/10.1001/jamapediatrics.2017.1579
2. Wackernagel D, Gustafsson A, Edstedt Bonamy A, Reims A, Ahlsson F, Elfving M, et al. Swedish national guideline for prevention and treatment of neonatal hypoglycaemia in newborn infants with gestational age ≥35 weeks. Acta Paediatr. 2020 ene 27;109(1):31-44. https://doi.org/10.1111/apa.14955
3. Committee on Fetus and Newborn A, Adamkin DH. Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics [internet]. 2011 Mar [citado 2022 abr 30];127(3):575-9. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21357346
4. Marles SL, Fccmg F, Casiro OG, Marles S. Persistent neonatal hypoglycemia: diagnosis and management [internet]. Paediatr Child Health. 1998 [citado 2022 abr 30];3(1):16-9. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851256/pdf/pch03016.pdf
5. Edwards T, Harding JE. Clinical aspects of neonatal hypoglycemia: a mini review. Front Pediatr [internet]. 2020 [citado 2022 abr 30];8:562251. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/33489995
6. Cortada ÁP, Iglesias Platas I. Hipoglucemia neonatal. An Pediatr Contin. 2013;11(3):142-51. https://doi.org/10.1016/S1696-2818(13)70130-6
7. Sharma A, Davis A, Shekhawat PS. Hypoglycemia in the preterm neonate: etiopathogenesis, diagnosis, management and long-term outcomes. Transl Pediatr 2017;6(4):335-348. https://doi.org/10.21037/tp.2017.10.06
8. Narvey MR, Marks SD. The screening and management of newborns at risk for low blood glucose. Paediatr Child Health. 2019 Dec;24(8):536-554. https://doi.org/10.1093/pch/pxz134
9. Thornton PS, Stanley CA, De Leon DD, Harris D, Haymond MW, Hussain K, et al. Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children. J Pediatr. 2015;167(2):238-45. https://doi.org/10.1016/j.jpeds.2015.03.057
10. Boardman J, Westman J, Ashton K, McDonald L, Meldrum G, O’Brien F, et al. Identification and management of neonatal hypoglycaemia in the full term infant framework for practice. Br Assoc Perinat Med [internet]. 2017 [citado 2022 abr 30]. Disponible en: https://hubble-live-assets.s3.amazonaws.com/bapm/file_asset/file/37/Identification_and_Management_of_Neonatal_Hypoglycaemia_in_the__full_term_infant_-_A_Framework_for_Practice_revised_Oct_2017.pdf
11. Alsaleem M, Saadeh L, Kamat D. Neonatal hypoglycemia: a review. Clin Pediatr (Phila). 2019;58(13):1381-6.
12. Wight NE. ABM clinical protocol #1: guidelines for glucose monitoring and treatment of hypoglycemia in term and late preterm neonates, revised 2021. Breastfeed Med. 2021 May;16(5):353-365. https://doi.org/10.1089/bfm.2021.29178.new
13. Lin R. Investigation on the occurrence of neonatal hypoglycemia in Meizhou People’s Hospital in 2017-2018. J Public Heal Prev Med [internet]. 2021 [citado 2022 may 1];151-4. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/wpr-876505
14. Kumar U, Singh BB. To determine the clinical profile of hypoglycemia in newborn and to determine the prevalence of hypoglycemia among neonates admitted in NICU. Eur J Mol Clin Med [internet]. 2020 [citado 2022 may 1];7(10):3738-43. Disponible en: https://ejmcm.com/article_9657.html
15. McInern TK, Adam HM, Campbell DE, DeWitt TG, Foy JM, Kamat DM, editores. Textbook of pediatric care. 2.ª ed. American Academy of Pediatrics; 2016.
16. Skovrlj R, Marks SD, Rodd C. Frequency and etiology of persistent neonatal hypoglycemia using the more stringent 2015 Pediatric Endocrine Society hypoglycemia guidelines. Paediatr Child Health [internet]. 2019 jun 21 [citado 2022 may 1];24(4):263-9. Disponible en: https://academic.oup.com/pch/article/24/4/263/5257707
17. Mantilla C, Toro M, Sepúlveda ME, Insuasty M, Di Filippo D, López JÁ, et al. Molecular and clinical characterization of Colombian patients suffering from type III glycogen storage disease. Biomedica. 2018;38:30-42. https://doi.org/10.7705/biomedica.v38i0.3454
18. Gandhi K. Approach to hypoglycemia in infants and children. Translat Pediatr. 2017;6(4). https://doi.org/10.21037/tp.2017.10.05
19. Puchalski ML, Russell TL, Karlsen KA. Neonatal hypoglycemia: is there a sweet spot? Crit Care Nurs Clin North Am [internet]. 2018 dic [citado 2022 may 1];30(4):467-80. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/30447807
20. McKinlay CJD, Alsweiler JM, Anstice NS, Burakevych N, Chakraborty A, Chase JG, et al. Association of neonatal glycemia with neurodevelopmental outcomes at 4.5 years. JAMA Pediatr. 2017;171(10):972-83. https://doi.org/10.1001/jamapediatrics.2017.1579
How to Cite
Silva Valencia, M. J., Atencia Herrera, C. M., Gómez, Ángela C., & Herrera, V. (2023). Persistent Hypoglycemia, a Rare and Underestimated Finding: Narrative Review of the Literature. Universitas Medica, 64(1). https://doi.org/10.11144/Javeriana.umed64-1.hipo
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