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Glucose metabolism and evaluation of hypoglycemia in neonates  

Kim, Eun Young (Department of Pediatrics, College of Medicine, Chosun University)
Publication Information
Clinical and Experimental Pediatrics / v.50, no.3, 2007 , pp. 223-229 More about this Journal
Abstract
The fetus is completely dependent on mother for glucose and other nutrient transfer across the placenta. At birth, when the maternal supply is discontinued, the neonate must adjust to an independent existence. The changes in the neonate's glucose homeostasis during this transition to the extrauterine environment are influenced by the mother's metabolism and intrinsic fetal and placental problems. Maturation of carbohydrate homeostasis results from a balance between substrate availability and coordination of developing hormonal, enzymatic, and neural systems. These mechanisms may not be fully developed in neonates, so the neonate is vulnerable to carbohydrate disequilibrium resulting in damage to the central nervous system. Hypoglycemia is a relatively common metabolic problem seen during newborn care. However its definition, management and long term sequalae remain controversial. Hyporglycemia occurs frequently as a transient disorder with excellent prognosis. It also may persist and recur and cause permanent neurological complications. Although the key to effective treatment of hypoglycemia is diagnostic specific, the maintenance of euglycemia is critical to the preservation of central nervous system function. This article discusses physiology of perinatal glucose homeostasis, focusing on evaluation and treatment of hypoglycemia.
Keywords
Neonate; Glucose Metabolism; Hypoglycemia;
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1 Sperling MA: Carbohydrate metabolism: Insulin and glucagon. In Tulchinsky D, Little AB(eds): Maternal-Fetal Endocrinology. Philadelphia: WB Saunders 1994:380-400
2 Cryer PE. Glucose homeostasis and hypoglycemia. In: Larson PR, Kronenberg HM, Melmed S, Polonsky KS, editors. Williams textbook of endocrinology. 10th ed. Philadelphia: WB Saunders Co 2002:1585-618
3 Granner D, Andreone T, Sasaki K, Beale E. Inhibition of transcription of the phosphoenol pyruvate carboxylase gene by insulin. Nature(Lond) 1983;305:549-51   DOI   ScienceOn
4 Cahill GF Jr. Starvation in man. N Engl J Med 1970;282: 668-75   DOI   ScienceOn
5 Wilker RE. Hypoglycemia and hyperglycemia. In: Cloherty JP, Eichenwald EC, Stark AR, editors. Manual of neonatal care 5th ed. Philadelphia: Lippincott Williams & Wilkins 2004:335-49
6 Lubchenco LO, Bard H: Incidence of hypoglycemia in newborn infants by birth weight and gestational age. Pediatrics 1971;47:831-8
7 Embleton ND, Ward-Platt MP. Management of hypoglycemia in the newborn. Curr Paediatr 2003;13:134-9   DOI   ScienceOn
8 Levitt Katz LE, Satin-Smith MS, Collett-Solberg P, Thornton PS, Baker L, Stanley CA, et al. Insulin-like growth factor binding protein-1 levels in the diagnosis of hypoglycemia caused by hyperinsulinism [see comments]. J Pediatr 1997; 131:171-3
9 Glaser B, Thornton P, Otonkoski T, Junien C. Genetics of neonatal hyperinsulinism. Arch Dis Child Fetal Neonatal Ed 2000;82:F79-86   DOI
10 Glaser B, Kesavan P, Heyaman M, Davis E, Cuesta A, Buchs A, et al. Familial hyperinsulinism caused by an activating glucokinase mutation N Engl J Med 1998;338:226-30   DOI   ScienceOn
11 Hay WW Jr. Disorders of Glucose Metabolism. In: Rudolph CD, Rudolph AM, Hostetter MK, Lister G, Siegel NJ, editors. Rudolph's Pediatrics. 21th ed. New York : McGraw- Hill 2002:155-61
12 Bier DM, Leake RD, Haymond MW, Arnold KJ, Gruenke LD, Sperling MA, et al. Measurement of true glucose production rates in infancy and childhood with 6,6-dideuteroglucose. Diabetes 1977;26:1016-23   DOI   ScienceOn
13 McGarry JD. New perspectives in the regulation of ketogenesis. Diabetes 1979;28:517-23   DOI
14 Cornblath M, Hawdon JM, Williams AF, Aynsley-Green A, Ward-Platt MP, Schwartz R, et al. Controversies regarding definition of neonatal hypoglycemia; suggested operational thresholds. Pediatrics 2000;105:1141-5   DOI   ScienceOn
15 Lovinger RD, Kaplan SL, Grumbach MM: Congenital hypopitruitarism associated with neonatal hypoglycemia and microphallus: Four cases secondary to hypothalamic hormone deficiencies. J Pediatr 1975;87:1171-81   DOI
16 Kalhan SC, Parimi PS. Disorders of carbohydrate metabolism. In: Martin RJ, Fanaroff AA, Walsh MC, editors. Fanaroff and Martin's Neonatal-perinatal medicine. Diseases of the fetus and infant. 8th ed. Philadelphia : Mosby 2006:1467-589
17 Creswell JS, Warburton D, Susa JB, Cowett RM, Oh Wl. Hyperviscosity in the newborn lamb produces pertubation in glucose homeostasis. Pediatr Res 1981;15:1348-50   DOI   ScienceOn
18 Sperling MA, Menon RK. Differential diagnosis and management of neonatal hypoglycemia. Pediatr Clin North Am 2004;41:703-23
19 Stanley CA, Baker L. Hyperinsulinism in infants and children; diagnosis and therapy. Adv Pediatr 1976;23:315-55
20 Stanley CA, Thornton PS, Finegold DN, Sperling MA. Hypoglycemia in neonates and infants. In Sperling MA, editor. Pediatric endocrinology 2nd ed. Philadelphia: WB Saunders Co 2002:135-59
21 Pettenati MJ, Haines JL. Higgins RR, Wappner RS, Palmer CG, Weaver DDl. Wiedemann-Beckwith syndrome: presentation of clinical and cytogenic data on 22 new cases and review of the literature. Hum Genet 1986;74:143-54   DOI
22 Finegold DN, Stanley CA, Baker L. Glycemic response to glucagon during fasting hypoglycemia; an aid in the diagnosis of hyperinsulinism. J Pediatr 1980;96:257-9   DOI
23 Girard J. Gluconeogenesis in late fetal and early neonatal life. Biol Neonate 1986;50:237-58   DOI   ScienceOn
24 de Lonlay-Debeney P, Poggi-Travert F, Fournet JC, Sempoux C, Vici CD, Brunnele F, et al. Clinical features of 52 neonates with hyperinsulinism. N Engl J Med 1999;340: 1169-75   DOI   ScienceOn
25 Lubchenco LO, Bard H. Incidence of hypoglycemia in newborn infants classified by birth weight and gestational age. Pediatrics 1971;47:831-8
26 Schultz K, Soltesz G: Transient hyperinsulinism in asphyxiated newborn infants. Acta Paediatr Hung 1991;31:47-52
27 Whipple AO, Fratz DK. Adenoma of islet cells with hyperinsulinism: a review. Ann Surg 1935;101:1299-310   DOI   ScienceOn
28 Shilyansky J, Fisher S, Cutz E, Perlman K, Filler RM. Is 95% pancreatectomy the procedure of chosice for treatment of persistent hyperinsulinemic hypoglycemia of the neonate? J Pediatr Surg 1997;32:342-6   DOI   ScienceOn
29 Bloch CA, Ozbun MA, Khan SA. Gycogen phosphorylase; developmental expression in rat liver. Biol Neonate 1993;63: 113-9   DOI   ScienceOn
30 Huijmans JG, Duran M, De Klerk JB, Rovers MJ, Scholte HR. Functional hyperactivity of hepatic glutamate dehydrogenase as a cause of the hyperinsulinism/hyperammonemia syndrome: effect of treatment. Pediatrics 2000;106:596-600   DOI   ScienceOn