Re-evaluating “transitional neonatal hypoglycemia”: mechanism and implications for management
Open accessAbstract
A Committee of the Pediatric Endocrine Society was recently formed to develop guidelines for evaluation and management of hypoglycemia in neonates, infants, and children. To aid in formulating recommendations for neonates, in this review, we analyzed available data on the brief period of hypoglycemia, which commonly is observed in normal newborns during the transition from fetal to extrauterine life, hereafter referred to as transitional neonatal hypoglycemia in normal newborns. The goal was to better understand the mechanism underlying this phenomenon in order to formulate recommendations for recognizing neonates requiring diagnosis and treatment during the first days of life for disorders causing severe and persistent hypoglycemia.
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It may be difficult to identify and distinguish newborn infants with a persistent hypoglycemia disorder from those with transitional low glucose levels in the initial 48 hours of life.
“Second, it may be difficult to identify and distinguish newborn infants with a persistent hypoglycemia disorder from those with transitional low glucose levels in the initial 48 hours of life, as detailed in the separate document on transitional neonatal hypoglycemia prepared by our committee.3”
From Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children (2015) · cites this paper as [3]
During the first 24-48 hours of life, as normal neonates transition from intrauterine to extrauterine life, their plasma glucose concentrations are typically lower than later in life.
“During the first 24–48 hours of life, as normal neonates transition from intrauterine to extrauterine life, their plasma glucose (PG) concentrations are typically lower than later in life.1–3”
From Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children (2015) · cites this paper as [3]
Hyperketonemia does not occur during transitional neonatal hypoglycemia in normal newborns in the first 1-2 days of life.
“(hyperketonemia does not occur during transitional neonatal hypoglycemia in normal newborns in the first 1–2 days of life3)”
From Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children (2015) · cites this paper as [3]
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“Second, it may be difficult to identify and distinguish newborn infants with a persistent hypoglycemia disorder from those with transitional low glucose levels in the initial 48 hours of life, as detailed in the separate document on transitional neonatal hypoglycemia prepared by our committee.(3) Third, the first few…”
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Self-citation
- Authors
- Stanley, C. A., Rozance, P. J., Thornton, P. S., De Leon, D. D., Harris, D., Haymond, M. W., Hussain, K., Levitsky, L. L., Murad, M. H., Simmons, R. A., Sperling, M. A., Weinstein, D. A., White, N. H., & Wolfsdorf, J. I.
- Affiliations
- Children's Hospital of Philadelphia (US)
- University of Colorado Anschutz (US)
- Cook Children's Medical Center (US)
- Waikato Hospital (NZ)
- Texas Children's Hospital (US)
- Great Ormond Street Hospital (GB)
- Massachusetts General Hospital (US)
- Mayo Clinic (US)
- Children's Hospital of Pittsburgh (US)
- University of Florida Health (US)
- St. Louis Children's Hospital (US)
- Boston Children's Hospital (US)
- Corresponding author
- Stanley, Charles A.
- ORCID
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2015-06
- Volume
- 166
- Issue
- 6
- Pages
- 1520-1525.e1
- ISSN
- 0022-3476 (ISSN-L)
- PMC
- PMC4659381
- OpenAlex
- W1959202321
- Cited by
- 245
- References
- 57
- Citations by year
- 2026: 19 · 2025: 13 · 2024: 20 · 2023: 21 · 2022: 17 · 2021: 29 · 2020: 31 · 2019: 25 · 2018: 22 · 2017: 21 · 2016: 21 · 2015: 6
- FWCI
- 4.47
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Journal of Pediatrics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK053012, R37DK056268, P30DK092950)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal Health and Biochemistry
- Keywords
- neonatal hypoglycemia, neonatal transition, hypoglycemia management, hypoglycemia diagnosis
- MeSH terms
- Blood Glucose, Fetal Diseases, Humans, Hypoglycemia, Infant, Newborn
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