Notes

Hypoglycemia of the Newborn

Types:
1. Transitional (<72 hours)
2. Persistent

Definitions of a safe range:
1. Normative ranges (What the majority of neonates have reached by any given age)
2. Symptoms (jitters/tremors, cyanosis, convulsions, apneic spells, tachypnea, lethargy)
- These symptoms overlap with other conditions such as meningitis, or seizures unrelated to hypoglycemia
- While Whipple's triad (signs/symptoms, low serum glucose and resolution w/ glucose administration) is not used diagnostically, it can help to establish hypoglycemia as a cause for the symptoms and should be documented
3. Sequelae (some studies have used neurological changes or consequences of low glucose to determine a safe range)
- this has been challenging as there is a great deal of variability even in normal glucose levels, so hard to find correlations between levels and sequelae
4. physiologic changes (rise in ketones, growth hormone, decrease in insulin etc)

Based on this, the generally accepted numbers are:
Transitional: 2.6mmol
Persistent: 3.3mmol