Hyperinsulinaemic hypoglycaemia in small for dates babies
Open accessAbstract
Blood glucose concentrations were measured prospectively in 27 small for dates infants in the first 48 hours after birth: 10 infants became hypoglycaemic. Of these, five had inappropriately raised plasma insulin concentrations. Plasma free fatty acids were lower and carbohydrate intake higher in these five infants, further supporting the diagnosis of hyperinsulinism. The hypoglycaemia recurred in four of the five hyperinsulinaemic infants, but in none of those who were not hyperinsulinaemic. Hyperinsulinism is common in small for dates babies. It is important to recognise this because hypoglycaemia is likely to recur and appropriate treatment is needed to prevent long term sequelae.
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There is no assurance that the plasma lactate level will be sufficiently elevated to compensate for low glucose in high-risk neonates.
“Of concern, as noted previously,3 plasma ketone levels are suppressed during hypoglycemia in high-risk neonates, making them particularly vulnerable to hypoglycemia-induced brain damage, and there is no assurance the plasma lactate level will be sufficiently elevated to compensate for low glucose.27,28,30,39”
From Recommendations from the Pediatric Endocrine Society for evaluation and management of persistent hypoglycemia in neonates, infants, and children (2015) · cites this paper as [28]
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Cites
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Self-citation
- Authors
- Collins, J. E., Leonard, J. V., Teale, D., Marks, V, Williams, D. M., Kennedy, C. R., & Hall, M. A.
- ORCID
- Marks, V
- Venue
- Archives of Disease in Childhood
- Publisher
- BMJ
- Published
- 1990-10-01
- Volume
- 65
- Issue
- 10
- Pages
- 1118-1120
- ISSN
- 0003-9888 (ISSN-L)
- 1468-2044
- PMC
- PMC1792359
- OpenAlex
- W2094102899
- Cited by
- 110
- References
- 11
- Citations by year
- 2026: 2 · 2024: 4 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 7 · 2017: 3 · 2016: 6 · 2015: 6 · 2014: 1 · 2013: 6 · 2012: 1
- FWCI
- 3.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Disease in Childhood (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- hyperinsulinemic hypoglycemia, neonatal hypoglycemia, plasma insulin, plasma free fatty acids, neonatal blood glucose
- MeSH terms
- C-Peptide, Dietary Carbohydrates, Fatty Acids, Nonesterified, Humans, Hyperinsulinism, Hypoglycemia, Infant, Newborn, Infant, Small for Gestational Age, Prospective Studies
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