Skip to main content
Bulletin of the World Health Organization logoLink to Bulletin of the World Health Organization
. 1997;75(3):261–290.

Hypoglycaemia of the newborn: a review.

A F Williams 1
PMCID: PMC2486945  PMID: 9277014

Abstract

It is almost a century since hypoglycaemia (a reduction in the glucose concentration of circulating blood) was first described in children, and over 50 years since the condition was first recognized in infants. Nevertheless, controversy still surrounds the definition, significance, and management of neonatal hypoglycaemia. Technological developments such as bedside glucose monitoring have, paradoxically, exacerbated rather than eased the situation. This article reviews the literature on hypoglycaemia of the newborn, and covers the following: historical aspects; glucose homeostasis and metabolic adaptation at birth; the effect of low blood glucose levels on the central nervous system; the definition of hypoglycaemia; screening; prevention; treatment; research needs; and concludes with recommendations for prevention and management.

Full text

PDF
290

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adam P. A., Räihä N., Rahiala E. L., Kekomäki M. Oxidation of glucose and D-B-OH-butyrate by the early human fetal brain. Acta Paediatr Scand. 1975 Jan;64(1):17–24. doi: 10.1111/j.1651-2227.1975.tb04375.x. [DOI] [PubMed] [Google Scholar]
  2. Altman D. G., Coles E. C. Nomograms for precise determination of birth weight for dates. Br J Obstet Gynaecol. 1980 Feb;87(2):81–86. doi: 10.1111/j.1471-0528.1980.tb04498.x. [DOI] [PubMed] [Google Scholar]
  3. Amiel S. A. Nutrition of the brain: macronutrient supply. Proc Nutr Soc. 1994 Jul;53(2):401–405. doi: 10.1079/pns19940045. [DOI] [PubMed] [Google Scholar]
  4. Anday E. K., Stanley C. A., Baker L., Delivoria-Papadopoulos M. Plasma ketones in newborn infants: absence of suckling ketosis. J Pediatr. 1981 Apr;98(4):628–630. doi: 10.1016/s0022-3476(81)80781-0. [DOI] [PubMed] [Google Scholar]
  5. Anderson D. M., Kliegman R. M. The relationship of neonatal alimentation practices to the occurrence of endemic necrotizing enterocolitis. Am J Perinatol. 1991 Jan;8(1):62–67. doi: 10.1055/s-2007-999344. [DOI] [PubMed] [Google Scholar]
  6. Anderson S., Shakya K. N., Shrestha L. N., Costello A. M. Hypoglycaemia: a common problem among uncomplicated newborn infants in Nepal. J Trop Pediatr. 1993 Oct;39(5):273–277. doi: 10.1093/tropej/39.5.273. [DOI] [PubMed] [Google Scholar]
  7. Aynsley-Green A. Glucose: a fuel for thought! J Paediatr Child Health. 1991 Feb;27(1):21–30. doi: 10.1111/j.1440-1754.1991.tb00340.x. [DOI] [PubMed] [Google Scholar]
  8. Beard A. G., Panos T. C., Marasigan B. V., Eminians J., Kennedy H. F., Lamb J. Perinatal stress and the premature neonate. II. Effect of fluid and calorie deprivation on blood glucose. J Pediatr. 1966 Mar;68(3):329–343. doi: 10.1016/s0022-3476(66)80235-4. [DOI] [PubMed] [Google Scholar]
  9. Beeby P. J., Jeffery H. Risk factors for necrotising enterocolitis: the influence of gestational age. Arch Dis Child. 1992 Apr;67(4 Spec No):432–435. doi: 10.1136/adc.67.4_spec_no.432. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Bier D. M., Leake R. D., Haymond M. W., Arnold K. J., Gruenke L. D., Sperling M. A., Kipnis D. M. Measurement of "true" glucose production rates in infancy and childhood with 6,6-dideuteroglucose. Diabetes. 1977 Nov;26(11):1016–1023. doi: 10.2337/diab.26.11.1016. [DOI] [PubMed] [Google Scholar]
  11. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
  12. Book L. S., Herbst J. J., Jung A. L. Comparison of fast- and slow-feeding rate schedules to the development of necrotizing enterocolitis. J Pediatr. 1976 Sep;89(3):463–466. doi: 10.1016/s0022-3476(76)80552-5. [DOI] [PubMed] [Google Scholar]
  13. Bougneres P. F., Lemmel C., Ferré P., Bier D. M. Ketone body transport in the human neonate and infant. J Clin Invest. 1986 Jan;77(1):42–48. doi: 10.1172/JCI112299. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Brown E. G., Sweet A. Y. Preventing necrotizing enterocolitis in neonates. JAMA. 1978 Nov 24;240(22):2452–2454. [PubMed] [Google Scholar]
  15. CORNBLATH M., ODELL G. B., LEVIN E. Y. Symptomatic neonatal hypoglycemia associated with toxemia of pregnancy. J Pediatr. 1959 Nov;55:545–562. doi: 10.1016/s0022-3476(59)80239-0. [DOI] [PubMed] [Google Scholar]
  16. Carter P. E., Lloyd D. J., Duffty P. Glucagon for hypoglycaemia in infants small for gestational age. Arch Dis Child. 1988 Oct;63(10):1264–1266. doi: 10.1136/adc.63.10.1264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Chance G. W., Bower B. D. Hypoglycaemia and temporary hyperglycaemia in infants of low birth weight for materity. Arch Dis Child. 1966 Jun;41(217):279–285. doi: 10.1136/adc.41.217.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Chantler C., Baum J. D., Norman D. A. Dextrostix in the diagnosis of neonatal hypoglycaemia. Lancet. 1967 Dec 30;2(7531):1395–1396. doi: 10.1016/s0140-6736(67)93026-7. [DOI] [PubMed] [Google Scholar]
  19. Collins J. E., Leonard J. V. Hyperinsulinism in asphyxiated and small-for-dates infants with hypoglycaemia. Lancet. 1984 Aug 11;2(8398):311–313. doi: 10.1016/s0140-6736(84)92685-0. [DOI] [PubMed] [Google Scholar]
  20. Collins J. E., Leonard J. V., Teale D., Marks V., Williams D. M., Kennedy C. R., Hall M. A. Hyperinsulinaemic hypoglycaemia in small for dates babies. Arch Dis Child. 1990 Oct;65(10):1118–1120. doi: 10.1136/adc.65.10.1118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Cornblath M., Schwartz R., Aynsley-Green A., Lloyd J. K. Hypoglycemia in infancy: the need for a rational definition. A Ciba Foundation discussion meeting. Pediatrics. 1990 May;85(5):834–837. [PubMed] [Google Scholar]
  22. Cornblath M., Schwartz R. Hypoglycemia in the neonate. J Pediatr Endocrinol. 1993 Apr-Jun;6(2):113–129. [PubMed] [Google Scholar]
  23. Cowett R. M., Oh W., Schwartz R. Persistent glucose production during glucose infusion in the neonate. J Clin Invest. 1983 Mar;71(3):467–475. doi: 10.1172/JCI110791. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Denne S. C., Kalhan S. C. Glucose carbon recycling and oxidation in human newborns. Am J Physiol. 1986 Jul;251(1 Pt 1):E71–E77. doi: 10.1152/ajpendo.1986.251.1.E71. [DOI] [PubMed] [Google Scholar]
  25. Dombrowski G. J., Jr, Swiatek K. R., Chao K. L. Lactate, 3-hydroxybutyrate, and glucose as substrates for the early postnatal rat brain. Neurochem Res. 1989 Jul;14(7):667–675. doi: 10.1007/BF00964877. [DOI] [PubMed] [Google Scholar]
  26. Epstein M. F., Nicholls E., Stubblefield P. G. Neonatal hypoglycemia after beta-sympathomimetic tocolytic therapy. J Pediatr. 1979 Mar;94(3):449–453. doi: 10.1016/s0022-3476(79)80600-9. [DOI] [PubMed] [Google Scholar]
  27. FARQUHAR J. W. Control of the blood sugar level in the neonatal period. Arch Dis Child. 1954 Dec;29(148):519–530. doi: 10.1136/adc.29.148.519. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. FARQUHAR J. W. The significance of hypoglycaemia in the newborn infant of the diabetic woman. Arch Dis Child. 1956 Jun;31(157):203–211. doi: 10.1136/adc.31.157.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Fernandes J., Berger R. Hypoglycaemia: principles of diagnosis and treatment in children. Baillieres Clin Endocrinol Metab. 1993 Jul;7(3):591–609. doi: 10.1016/s0950-351x(05)80209-5. [DOI] [PubMed] [Google Scholar]
  30. Fernandes J., Berger R., Smit G. P. Lactate as a cerebral metabolic fuel for glucose-6-phosphatase deficient children. Pediatr Res. 1984 Apr;18(4):335–339. doi: 10.1203/00006450-198404000-00006. [DOI] [PubMed] [Google Scholar]
  31. Fluge G. Clinical aspects of neonatal hypoglycaemia. Acta Paediatr Scand. 1974 Nov;63(6):826–832. doi: 10.1111/j.1651-2227.1974.tb04871.x. [DOI] [PubMed] [Google Scholar]
  32. Fox R. E., Redstone D. Sources of error in glucose determinations in neonatal blood by glucose oxidase methods, including Dextrostix. Am J Clin Pathol. 1976 Oct;66(4):658–666. doi: 10.1093/ajcp/66.4.658. [DOI] [PubMed] [Google Scholar]
  33. Gardosi J., Chang A., Kalyan B., Sahota D., Symonds E. M. Customised antenatal growth charts. Lancet. 1992 Feb 1;339(8788):283–287. doi: 10.1016/0140-6736(92)91342-6. [DOI] [PubMed] [Google Scholar]
  34. Gerich J. E. Control of glycaemia. Baillieres Clin Endocrinol Metab. 1993 Jul;7(3):551–586. doi: 10.1016/s0950-351x(05)80207-1. [DOI] [PubMed] [Google Scholar]
  35. Ginsburg B. E., Lindblad B. S., Persson B., Zetterström R. Plasma valine and urinary C-peptide in infants. The effect of substituting breast-feeding with formula or formula with human milk. Acta Paediatr Scand. 1985 Jul;74(4):615–616. doi: 10.1111/j.1651-2227.1985.tb11044.x. [DOI] [PubMed] [Google Scholar]
  36. Goldman H. I. Feeding and necrotizing enterocolitis. Am J Dis Child. 1980 Jun;134(6):553–555. doi: 10.1001/archpedi.1980.02130180011004. [DOI] [PubMed] [Google Scholar]
  37. Gotlin R. W., Silver H. K. Neonatal hypoglycaemia, hyperinsulinism, and absence of pancreatic alpha-cells. Lancet. 1970 Jun 20;760(1):1346–1346. doi: 10.1016/s0140-6736(70)91946-x. [DOI] [PubMed] [Google Scholar]
  38. Grazaitis D. M., Sexson W. R. Erroneously high Dextrostix values caused by isopropyl alcohol. Pediatrics. 1980 Aug;66(2):221–223. [PubMed] [Google Scholar]
  39. Griffiths A. D., Bryant G. M. Assessment of effects of neonatal hypoglycaemia. A study of 41 cases with matched controls. Arch Dis Child. 1971 Dec;46(250):819–827. doi: 10.1136/adc.46.250.819. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Gutberlet R. L., Cornblath M. Neonatal hypoglycemia revisited, 1975. Pediatrics. 1976 Jul;58(1):10–17. [PubMed] [Google Scholar]
  41. HAWORTH J. C., MCRAE K. N. THE NEUROLOGICAL AND DEVELOPMENTAL EFFECTS OF NEONATAL HYPOGLYCEMIA: A FOLLOW-UP OF 22 CASES. Can Med Assoc J. 1965 Apr 17;92:861–865. [PMC free article] [PubMed] [Google Scholar]
  42. Hales C. N., Barker D. J. Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia. 1992 Jul;35(7):595–601. doi: 10.1007/BF00400248. [DOI] [PubMed] [Google Scholar]
  43. Hall D. M., Michel J. M. Screening in infancy. Arch Dis Child. 1995 Jan;72(1):93–96. doi: 10.1136/adc.72.1.93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Hawdon J. M., Aynsley-Green A., Alberti K. G., Ward Platt M. P. The role of pancreatic insulin secretion in neonatal glucoregulation. I. Healthy term and preterm infants. Arch Dis Child. 1993 Mar;68(3 Spec No):274–279. doi: 10.1136/adc.68.3_spec_no.274. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Hawdon J. M., Aynsley-Green A., Ward Platt M. P. Neonatal blood glucose concentrations: metabolic effects of intravenous glucagon and intragastric medium chain triglyceride. Arch Dis Child. 1993 Mar;68(3 Spec No):255–261. doi: 10.1136/adc.68.3_spec_no.255. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Hawdon J. M., Hubbard M., Hales C. N., Clark P. M. Use of specific immunoradiometric assay to determine preterm neonatal insulin-glucose relations. Arch Dis Child Fetal Neonatal Ed. 1995 Nov;73(3):F166–F169. doi: 10.1136/fn.73.3.f166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Hawdon J. M., Ward Platt M. P., Aynsley-Green A. Patterns of metabolic adaptation for preterm and term infants in the first neonatal week. Arch Dis Child. 1992 Apr;67(4 Spec No):357–365. doi: 10.1136/adc.67.4_spec_no.357. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Hawdon J. M., Ward Platt M. P., Aynsley-Green A. Prevention and management of neonatal hypoglycaemia. Arch Dis Child Fetal Neonatal Ed. 1994 Jan;70(1):F60–F65. doi: 10.1136/fn.70.1.f60. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Hawdon J. M., Ward Platt M. P., McPhail S., Cameron H., Walkinshaw S. A. Prediction of impaired metabolic adaptation by antenatal Doppler studies in small for gestational age fetuses. Arch Dis Child. 1992 Jul;67(7 Spec No):789–792. doi: 10.1136/adc.67.7_spec_no.789. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Hawdon J. M., Ward Platt M. P. Metabolic adaptation in small for gestational age infants. Arch Dis Child. 1993 Mar;68(3 Spec No):262–268. doi: 10.1136/adc.68.3_spec_no.262. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Hawdon J. M., Weddell A., Aynsley-Green A., Ward Platt M. P. Hormonal and metabolic response to hypoglycaemia in small for gestational age infants. Arch Dis Child. 1993 Mar;68(3 Spec No):269–273. doi: 10.1136/adc.68.3_spec_no.269. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Haworth J. C., Vidyasagar D. Hypoglycemia in the newborn. Clin Obstet Gynecol. 1971 Sep;14(3):821–839. doi: 10.1097/00003081-197109000-00010. [DOI] [PubMed] [Google Scholar]
  53. Hay W. W., Jr, Osberg I. M. The "eyetone" blood glucose reflectance colorimeter evaluated for in vitro and in vivo accuracy and clinical efficacy. Clin Chem. 1983 Mar;29(3):558–560. [PubMed] [Google Scholar]
  54. Hay W. W., Jr The placenta. Not just a conduit for maternal fuels. Diabetes. 1991 Dec;40 (Suppl 2):44–50. doi: 10.2337/diab.40.2.s44. [DOI] [PubMed] [Google Scholar]
  55. Haymond M. W., Karl I. E., Pagliara A. S. Increased gluconeogenic substrates in the small-for-gestational-age infant. N Engl J Med. 1974 Aug 15;291(7):322–328. doi: 10.1056/NEJM197408152910702. [DOI] [PubMed] [Google Scholar]
  56. Heck L. J., Erenberg A. Serum glucose levels in term neonates during the first 48 hours of life. J Pediatr. 1987 Jan;110(1):119–122. doi: 10.1016/s0022-3476(87)80303-7. [DOI] [PubMed] [Google Scholar]
  57. Herrera A. J., Hsiang Y. H. Comparison of various methods of blood sugar screening in newborn infants. J Pediatr. 1983 May;102(5):769–772. doi: 10.1016/s0022-3476(83)80255-8. [DOI] [PubMed] [Google Scholar]
  58. Ho K. L., Loke H. L., Tan K. W. Accuracy and reliability of two methods of screening for hypoglycemia in neonates. J Singapore Paediatr Soc. 1991;33(3-4):156–158. [PubMed] [Google Scholar]
  59. Holtrop P. C., Madison K. A., Kiechle F. L., Karcher R. E., Batton D. G. A comparison of chromogen test strip (Chemstrip bG) and serum glucose values in newborns. Am J Dis Child. 1990 Feb;144(2):183–185. doi: 10.1001/archpedi.1990.02150260063029. [DOI] [PubMed] [Google Scholar]
  60. Holtrop P. C. The frequency of hypoglycemia in full-term large and small for gestational age newborns. Am J Perinatol. 1993 Mar;10(2):150–154. doi: 10.1055/s-2007-994649. [DOI] [PubMed] [Google Scholar]
  61. Hume R., Burchell A. Abnormal expression of glucose-6-phosphatase in preterm infants. Arch Dis Child. 1993 Feb;68(2):202–204. doi: 10.1136/adc.68.2.202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Jones R. A., Roberton N. R. Small for dates babies: are they really a problem? Arch Dis Child. 1986 Sep;61(9):877–880. doi: 10.1136/adc.61.9.877. [DOI] [PMC free article] [PubMed] [Google Scholar]
  63. Joosten K. F., Schellekens A. P., Waelkens J. J., Wulffraat N. M. Foutieve diagnose 'neonatale hypoglykemie' door onjuist bewaren van bloedmonsters. Ned Tijdschr Geneeskd. 1991 Sep 14;135(37):1691–1694. [PubMed] [Google Scholar]
  64. Jouppila R., Kauppila A., Tuimala R., Pakarinen A., Moilanen K. Maternal, fetal and neonatal effects of beta-adrenergic stimulation in connection with cesarean section. Acta Obstet Gynecol Scand. 1980;59(6):489–493. doi: 10.3109/00016348009155437. [DOI] [PubMed] [Google Scholar]
  65. Kalhan S. C., Oliven A., King K. C., Lucero C. Role of glucose in the regulation of endogenous glucose production in the human newborn. Pediatr Res. 1986 Jan;20(1):49–52. doi: 10.1203/00006450-198601000-00013. [DOI] [PubMed] [Google Scholar]
  66. Kalhan S. C., Savin S. M., Adam P. A. Attenuated glucose production rate in newborn infants of insulin-dependent diabetic mothers. N Engl J Med. 1977 Feb 17;296(7):375–376. doi: 10.1056/NEJM197702172960706. [DOI] [PubMed] [Google Scholar]
  67. Kalhan S. C., Savin S. M., Adam P. A. Measurement of glucose turnover in the human newborn with glucose-1-13C. J Clin Endocrinol Metab. 1976 Sep;43(3):704–707. doi: 10.1210/jcem-43-3-704. [DOI] [PubMed] [Google Scholar]
  68. Kaplan M., Blondheim O., Alon I., Eylath U., Trestian S., Eidelman A. I. Screening for hypoglycemia with plasma in neonatal blood of high hematocrit value. Crit Care Med. 1989 Mar;17(3):279–282. doi: 10.1097/00003246-198903000-00016. [DOI] [PubMed] [Google Scholar]
  69. Koh T. H., Eyre J. A., Aynsley-Green A. Neonatal hypoglycaemia--the controversy regarding definition. Arch Dis Child. 1988 Nov;63(11):1386–1388. doi: 10.1136/adc.63.11.1386. [DOI] [PMC free article] [PubMed] [Google Scholar]
  70. Koivisto M., Blanco-Sequeiros M., Krause U. Neonatal symptomatic and asymptomatic hypoglycaemia: a follow-up study of 151 children. Dev Med Child Neurol. 1972 Oct;14(5):603–614. doi: 10.1111/j.1469-8749.1972.tb02642.x. [DOI] [PubMed] [Google Scholar]
  71. Kollee L. A., Monnens L. A., Cecjka V., Wilms R. M. Persistent neonatal hypoglycaemia due to glucagon deficiency. Arch Dis Child. 1978 May;53(5):422–424. doi: 10.1136/adc.53.5.422. [DOI] [PMC free article] [PubMed] [Google Scholar]
  72. Kraus H., Schlenker S., Schwedesky D. Developmental changes of cerebral ketone body utilization in human infants. Hoppe Seylers Z Physiol Chem. 1974 Feb;355(2):164–170. doi: 10.1515/bchm2.1974.355.1.164. [DOI] [PubMed] [Google Scholar]
  73. Ktorza A., Bihoreau M. T., Nurjhan N., Picon L., Girard J. Insulin and glucagon during the perinatal period: secretion and metabolic effects on the liver. Biol Neonate. 1985;48(4):204–220. doi: 10.1159/000242173. [DOI] [PubMed] [Google Scholar]
  74. Lang S., Lawrence C. J., Orme R. L. Cup feeding: an alternative method of infant feeding. Arch Dis Child. 1994 Oct;71(4):365–369. doi: 10.1136/adc.71.4.365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  75. Lilien L. D., Pildes R. S., Srinivasan G., Voora S., Yeh T. F. Treatment of neonatal hypoglycemia with minibolus and intraveous glucose infusion. J Pediatr. 1980 Aug;97(2):295–298. doi: 10.1016/s0022-3476(80)80499-9. [DOI] [PubMed] [Google Scholar]
  76. Lin H. C., Maguire C., Oh W., Cowett R. Accuracy and reliability of glucose reflectance meters in the high-risk neonate. J Pediatr. 1989 Dec;115(6):998–1000. doi: 10.1016/s0022-3476(89)80757-7. [DOI] [PubMed] [Google Scholar]
  77. Lindblad B. S. The venous plasma free amino acid levels during the first hours of life. I. After normal and short gestation and gestation complicated by hypertension, with special reference to the "small for dates" syndrome. Acta Paediatr Scand. 1970 Jan;59(1):13–20. [PubMed] [Google Scholar]
  78. Lubchenco L. O., Bard H. Incidence of hypoglycemia in newborn infants classified by birth weight and gestational age. Pediatrics. 1971 May;47(5):831–838. [PubMed] [Google Scholar]
  79. Lucas A. AIDS and human milk bank closures. Lancet. 1987 May 9;1(8541):1092–1093. doi: 10.1016/s0140-6736(87)90520-4. [DOI] [PubMed] [Google Scholar]
  80. Lucas A., Adrian T. E., Aynsley-Green A., Bloom S. R. Iatrogenic hyperinsulinism at birth. Lancet. 1980 Jan 19;1(8160):144–145. doi: 10.1016/s0140-6736(80)90619-4. [DOI] [PubMed] [Google Scholar]
  81. Lucas A., Boyes S., Bloom S. R., Aynsley-Green A. Metabolic and endocrine responses to a milk feed in six-day-old term infants: differences between breast and cow's milk formula feeding. Acta Paediatr Scand. 1981 Mar;70(2):195–200. doi: 10.1111/j.1651-2227.1981.tb05541.x. [DOI] [PubMed] [Google Scholar]
  82. Lucas A., Cole T. J. Breast milk and neonatal necrotising enterocolitis. Lancet. 1990 Dec 22;336(8730):1519–1523. doi: 10.1016/0140-6736(90)93304-8. [DOI] [PubMed] [Google Scholar]
  83. Lucas A., Morley R., Cole T. J. Adverse neurodevelopmental outcome of moderate neonatal hypoglycaemia. BMJ. 1988 Nov 19;297(6659):1304–1308. doi: 10.1136/bmj.297.6659.1304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  84. McKeown R. E., Marsh T. D., Amarnath U., Garrison C. Z., Addy C. L., Thompson S. J., Austin J. L. Role of delayed feeding and of feeding increments in necrotizing enterocolitis. J Pediatr. 1992 Nov;121(5 Pt 1):764–770. doi: 10.1016/s0022-3476(05)81913-4. [DOI] [PubMed] [Google Scholar]
  85. Mehta A. Hyperinsulinaemic hypoglycaemia in small for dates babies. Arch Dis Child. 1991 Jun;66(6):749–749. doi: 10.1136/adc.66.6.749-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  86. Mehta A., Wootton R., Cheng K. N., Penfold P., Halliday D., Stacey T. E. Effect of diazoxide or glucagon on hepatic glucose production rate during extreme neonatal hypoglycaemia. Arch Dis Child. 1987 Sep;62(9):924–930. doi: 10.1136/adc.62.9.924. [DOI] [PMC free article] [PubMed] [Google Scholar]
  87. Melichar V., Drahota Z., Hahn P. Ketone bodies in the blood of full term newborns, premature and dysmature infants and infants of diabetic mothers. Biol Neonat. 1967;11(1):23–28. doi: 10.1159/000240051. [DOI] [PubMed] [Google Scholar]
  88. Mestyán J., Schultz K., Soltész G., Horváth M. The metabolic effects of glucagon infusion in normoglycaemic and hypoglycaemic small-for-gestational-age infants. II. Changes in plasma amino acids. Acta Paediatr Acad Sci Hung. 1976;17(3):245–253. [PubMed] [Google Scholar]
  89. Mestyán J., Soltész G., Schultz K., Horváth M. Hyperaminoacidemia due to the accumulation of gluconeogenic amino acid precursors in hypoglycemic small-for-gestational age infants. J Pediatr. 1975 Sep;87(3):409–414. doi: 10.1016/s0022-3476(75)80644-5. [DOI] [PubMed] [Google Scholar]
  90. Milner R. D., Ashworth M. A., Barson A. J. Insulin release from human foetal pancreas in response to glucose, leucine and arginine. J Endocrinol. 1972 Mar;52(3):497–505. doi: 10.1677/joe.0.0520497. [DOI] [PubMed] [Google Scholar]
  91. NORVAL M. A. Blood sugar values in premature infants. J Pediatr. 1950 Feb;36(2):177–184. doi: 10.1016/s0022-3476(50)80203-2. [DOI] [PubMed] [Google Scholar]
  92. Nehlig A., Pereira de Vasconcelos A. Glucose and ketone body utilization by the brain of neonatal rats. Prog Neurobiol. 1993 Feb;40(2):163–221. doi: 10.1016/0301-0082(93)90022-k. [DOI] [PubMed] [Google Scholar]
  93. Owen O. E., Morgan A. P., Kemp H. G., Sullivan J. M., Herrera M. G., Cahill G. F., Jr Brain metabolism during fasting. J Clin Invest. 1967 Oct;46(10):1589–1595. doi: 10.1172/JCI105650. [DOI] [PMC free article] [PubMed] [Google Scholar]
  94. PEDERSEN J., BOJSEN-MØLLER B., POULSEN H. Blood sugar in newborn infants of diabetic mothers. Acta Endocrinol (Copenh) 1954 Jan;15(1):33–52. doi: 10.1530/acta.0.0150033. [DOI] [PubMed] [Google Scholar]
  95. Papagapiou M. P., Auer R. N. Regional neuroprotective effects of the NMDA receptor antagonist MK-801 (dizocilpine) in hypoglycemic brain damage. J Cereb Blood Flow Metab. 1990 Mar;10(2):270–276. doi: 10.1038/jcbfm.1990.44. [DOI] [PubMed] [Google Scholar]
  96. Patel M. S., Johnson C. A., Rajan R., Owen O. E. The metabolism of ketone bodies in developing human brain: development of ketone-body-utilizing enzymes and ketone bodies as precursors for lipid synthesis. J Neurochem. 1975 Dec;25(6):905–908. doi: 10.1111/j.1471-4159.1975.tb04428.x. [DOI] [PubMed] [Google Scholar]
  97. Pearce J. L., Buchanan L. F. Breast milk and breast feeding in very low birthweight infants. Arch Dis Child. 1979 Nov;54(11):897–899. doi: 10.1136/adc.54.11.897. [DOI] [PMC free article] [PubMed] [Google Scholar]
  98. Perelman R. H., Gutcher G. R., Engle M. J., MacDonald M. J. Comparative analysis of four methods for rapid glucose determination in neonates. Am J Dis Child. 1982 Dec;136(12):1051–1053. doi: 10.1001/archpedi.1982.03970480017003. [DOI] [PubMed] [Google Scholar]
  99. Persson B., Gentz J. The pattern of blood lipids, glycerol and ketone bodies during the neonatal period, infancy and childhood. Acta Paediatr Scand. 1966 Jul;55(4):353–362. doi: 10.1111/j.1651-2227.1966.tb08806.x. [DOI] [PubMed] [Google Scholar]
  100. Pildes R. S., Cornblath M., Warren I., Page-El E., Di Menza S., Merritt D. M., Peeva A. A prospective controlled study of neonatal hypoglycemia. Pediatrics. 1974 Jul;54(1):5–14. [PubMed] [Google Scholar]
  101. Procianoy R. S., Pinheiro C. E. Neonatal hyperinsulinism after short-term maternal beta sympathomimetic therapy. J Pediatr. 1982 Oct;101(4):612–614. doi: 10.1016/s0022-3476(82)80722-1. [DOI] [PubMed] [Google Scholar]
  102. Pryds O., Christensen N. J., Friis-Hansen B. Increased cerebral blood flow and plasma epinephrine in hypoglycemic, preterm neonates. Pediatrics. 1990 Feb;85(2):172–176. [PubMed] [Google Scholar]
  103. Pryds O., Greisen G., Friis-Hansen B. Compensatory increase of CBF in preterm infants during hypoglycaemia. Acta Paediatr Scand. 1988 Sep;77(5):632–637. doi: 10.1111/j.1651-2227.1988.tb10721.x. [DOI] [PubMed] [Google Scholar]
  104. Reynolds G. J., Davies S. A clinical audit of cotside blood glucose measurement in the detection of neonatal hypoglycaemia. J Paediatr Child Health. 1993 Aug;29(4):289–291. doi: 10.1111/j.1440-1754.1993.tb00513.x. [DOI] [PubMed] [Google Scholar]
  105. SMALLPEICE V., DAVIES P. A. IMMEDIATE FEEDING OF PREMATURE INFANTS WITH UNDILUTED BREAST-MILK. Lancet. 1964 Dec 26;2(7374):1349–1352. doi: 10.1016/s0140-6736(64)91152-3. [DOI] [PubMed] [Google Scholar]
  106. Sann L., Divry P., Lasne Y., Ruitton A. Effect of oral lipid administration on glucose homeostasis in small-for-gestational-age infants. Acta Paediatr Scand. 1982 Nov;71(6):923–927. doi: 10.1111/j.1651-2227.1982.tb09550.x. [DOI] [PubMed] [Google Scholar]
  107. Sann L., Mathieu M., Lasne Y., Ruitton A. Effect of oral administration of lipids with 67% medium chain triglycerides on glucose homeostasis in preterm neonates. Metabolism. 1981 Jul;30(7):712–716. doi: 10.1016/0026-0495(81)90088-3. [DOI] [PubMed] [Google Scholar]
  108. Sann L., Mousson B., Rousson M., Maire I., Bethenod M. Prevention of neonatal hypoglycaemia by oral lipid supplementation in low birth weight infants. Eur J Pediatr. 1988 Feb;147(2):158–161. doi: 10.1007/BF00442214. [DOI] [PubMed] [Google Scholar]
  109. Sann L., Ruitton A., Mathieu M., Bourgeois J., Genoud J. Effect of intravenous L-alanine administration on plasma glucose, insulin and glucagon, blood pyruvate, lactate and beta-hydroxybutyrate concentrations in newborn infants. Study in term and preterm newborn infants. Acta Paediatr Scand. 1978 May;67(3):297–302. doi: 10.1111/j.1651-2227.1978.tb16324.x. [DOI] [PubMed] [Google Scholar]
  110. Saudubray J. M., Narcy C., Lyonnet L., Bonnefont J. P., Poll The B. T., Munnich A. Clinical approach to inherited metabolic disorders in neonates. Biol Neonate. 1990;58 (Suppl 1):44–53. doi: 10.1159/000243299. [DOI] [PubMed] [Google Scholar]
  111. Schwartz R. Neonatal hypoglycemia. Back to basics in diagnosis and treatment. Diabetes. 1991 Dec;40 (Suppl 2):71–73. doi: 10.2337/diab.40.2.s71. [DOI] [PubMed] [Google Scholar]
  112. Settergren G., Lindblad B. S., Persson B. Cerebral blood flow and exchange of oxygen, glucose, ketone bodies, lactate, pyruvate and amino acids in infants. Acta Paediatr Scand. 1976 May;65(3):343–353. doi: 10.1111/j.1651-2227.1976.tb04896.x. [DOI] [PubMed] [Google Scholar]
  113. Sexson W. R. Incidence of neonatal hypoglycemia: a matter of definition. J Pediatr. 1984 Jul;105(1):149–150. doi: 10.1016/s0022-3476(84)80382-0. [DOI] [PubMed] [Google Scholar]
  114. Shah A., Stanhope R., Matthew D. Hazards of pharmacological tests of growth hormone secretion in childhood. BMJ. 1992 Jan 18;304(6820):173–174. doi: 10.1136/bmj.304.6820.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  115. Singh M., Singhal P. K., Paul V. K., Deorari A. K., Sundaram K. R., Ghorpade M. D., Agadi A. Neurodevelopmental outcome of asymptomatic & symptomatic babies with neonatal hypoglycaemia. Indian J Med Res. 1991 Feb;94:6–10. [PubMed] [Google Scholar]
  116. Singhal P. K., Singh M., Paul V. K., Malhotra A. K., Deorari A. K., Ghorpade M. D. A controlled study of sugar-fortified milk feeding for prevention of neonatal hypoglycaemia. Indian J Med Res. 1991 Oct;94:342–345. [PubMed] [Google Scholar]
  117. Skov L., Pryds O. Capillary recruitment for preservation of cerebral glucose influx in hypoglycemic, preterm newborns: evidence for a glucose sensor? Pediatrics. 1992 Aug;90(2 Pt 1):193–195. [PubMed] [Google Scholar]
  118. Srinivasan G., Pildes R. S., Cattamanchi G., Voora S., Lilien L. D. Plasma glucose values in normal neonates: a new look. J Pediatr. 1986 Jul;109(1):114–117. doi: 10.1016/s0022-3476(86)80588-1. [DOI] [PubMed] [Google Scholar]
  119. Stanley C. A., Anday E. K., Baker L., Delivoria-Papadopolous M. Metabolic fuel and hormone responses to fasting in newborn infants. Pediatrics. 1979 Nov;64(5):613–619. [PubMed] [Google Scholar]
  120. Sunehag A., Gustafsson J., Ewald U. Very immature infants (< or = 30 Wk) respond to glucose infusion with incomplete suppression of glucose production. Pediatr Res. 1994 Oct;36(4):550–555. doi: 10.1203/00006450-199410000-00024. [DOI] [PubMed] [Google Scholar]
  121. Thomas D. J., Dove A. F., Alberti K. G. Metabolic effects of salbutamol infusion during premature labour. Br J Obstet Gynaecol. 1977 Jul;84(7):497–499. doi: 10.1111/j.1471-0528.1977.tb12632.x. [DOI] [PubMed] [Google Scholar]
  122. Thurston J. H., Hauhart R. E., Schiro J. A. Lactate reverses insulin-induced hypoglycemic stupor in suckling-weanling mice: biochemical correlates in blood, liver, and brain. J Cereb Blood Flow Metab. 1983 Dec;3(4):498–506. doi: 10.1038/jcbfm.1983.77. [DOI] [PubMed] [Google Scholar]
  123. Togari H., Oda M., Wada Y. Mechanism of erroneous Dextrostix readings. Arch Dis Child. 1987 Apr;62(4):408–409. doi: 10.1136/adc.62.4.408. [DOI] [PMC free article] [PubMed] [Google Scholar]
  124. Vadasdi E., Jacobs E. HemoCue beta-glucose photometer evaluated for use in a neonatal intensive care unit. Clin Chem. 1993 Nov;39(11 Pt 1):2329–2332. [PubMed] [Google Scholar]
  125. Vidnes J., Oyasaeter S. Glucagon deficiency causing severe neonatal hypoglycemia in a patient with normal insulin secretion. Pediatr Res. 1977 Sep;11(9 Pt 1):943–949. doi: 10.1203/00006450-197709000-00001. [DOI] [PubMed] [Google Scholar]
  126. Whitby C., de Cates C. R., Roberton N. R. Infants weighing 1.8-2.5 kg: should they be cared for in neonatal units or postnatal wards? Lancet. 1982 Feb 6;1(8267):322–325. doi: 10.1016/s0140-6736(82)91578-1. [DOI] [PubMed] [Google Scholar]
  127. Williams P. R., Sperling M. A., Racasa Z. Blunting of spontaneous and alanine-stimulated glucagon secretion in newborn infants of diabetic mothers. Am J Obstet Gynecol. 1979 Jan 1;133(1):51–56. doi: 10.1016/0002-9378(79)90410-1. [DOI] [PubMed] [Google Scholar]
  128. Young R. S., Petroff O. A., Chen B., Aquila W. J., Jr, Gore J. C. Preferential utilization of lactate in neonatal dog brain: in vivo and in vitro proton NMR study. Biol Neonate. 1991;59(1):46–53. doi: 10.1159/000243321. [DOI] [PubMed] [Google Scholar]
  129. van den Bosch C. A., Bullough C. H. Effect of early suckling on term neonates' core body temperature. Ann Trop Paediatr. 1990;10(4):347–353. doi: 10.1080/02724936.1990.11747456. [DOI] [PubMed] [Google Scholar]

Articles from Bulletin of the World Health Organization are provided here courtesy of World Health Organization

RESOURCES