Management and TREATMENT of neonatal HYPOGLYCEMIA

How to TREAT a low glucose in a newborn?? WHEN is a Glucose level considered LOW in babies? WHEN to treat? What if the baby has SYMPTOMS? What about feeds? What is glucose GEL? When do we give a bolus? When do we increase Dextrose concentrations? What about the GIR? When do we use other medications e.g glucagon, diazoxide, steroids, octreotide??? When do we check other hormones and labs values!
This is probably our clinically most helpful video- so find out all the answers in the video!
For the PDF summary of THIS video, links to relevant articles (+ 50 free Multiple Choice Questions/ Answers and explanations!!), AND a bunch of other stuff, subscribe to our Neonatal Nuggets Newsletter here:
talatalksnicu....
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 16 years. She has won multiple teaching awards throughout her time as a neonatologist.
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References:
Giouleka S, Gkiouleka M, Tsakiridis I, Daniilidou A, Mamopoulos A, Athanasiadis A, Dagklis T. Diagnosis and Management of Neonatal Hypoglycemia: A Comprehensive Review of Guidelines. Children (Basel). 2023 Jul 14;10(7):1220. doi: 10.3390/children10071220. PMID: 37508719; PMCID: PMC10378472
Pediatrics. 2011;127(3). doi:10.1542/peds.2010-3851
www.liebertpub...
Harris DL, Weston PJ, Signal M, Chase JG, Harding JE. Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial. Lancet. 2013 Dec 21;382(9910):2077-83. doi: 10.1016/S0140-6736(13)61645-1. Epub 2013 Sep 25. PMID: 24075361.
Gupta K, Amboiram P, Balakrishnan U, C A, Abiramalatha T, Devi U. Dextrose Gel for Neonates at Risk With Asymptomatic Hypoglycemia: A Randomized Clinical Trial. Pediatrics. 2022 Jun 1;149(6):e2021050733. doi: 10.1542/peds.2021-050733. PMID: 35582897.
Harris DL, Gamble GD, Harding JE; CHYLD Study Group. Outcome at 4.5 years after dextrose gel treatment of hypoglycaemia: follow-up of the Sugar Babies randomised trial. Arch Dis Child Fetal Neonatal Ed. 2023 Mar;108(2):121-128. doi: 10.1136/archdischild-2022-324148. Epub 2022 Aug 8. PMID: 35940872; PMCID: PMC9905356.
St Clair SL, Harding JE, O'Sullivan JM, Gamble GD, Alsweiler JM, Vatanen T; hPOD Study Group. Effect of prophylactic dextrose gel on the neonatal gut microbiome. Arch Dis Child Fetal Neonatal Ed. 2022 Sep;107(5):501-507. doi: 10.1136/archdischild-2021-322757. Epub 2021 Dec 2. PMID: 34857640; PMCID: PMC9160211
www.med.unc.ed...
Vanhatalo T, Tammela O. Glucose infusions into peripheral veins in the management of neonatal hypoglycemia--20% instead of 15%? Acta Paediatr. 2010 Mar;99(3):350-3. doi: 10.1111/j.1651-2227.2009.01237.x. Epub 2009 Apr 14. PMID: 19397539.
Sweet CB, Grayson S, Polak M. Management strategies for neonatal hypoglycemia. J Pediatr Pharmacol Ther. 2013 Jul;18(3):199-208. doi: 10.5863/1551-6776-18.3.199. PMID: 24052783; PMCID: PMC3775554
Adamkin DH. Neonatal hypoglycemia. Semin Fetal Neonatal Med. 2017 Feb;22(1):36-41. doi: 10.1016/j.siny.2016.08.007. Epub 2016 Sep 4. PMID: 27605513
Watch this too: • The CHYLD Study
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**TIMESTAMPS**
00:32 Definition of hypoglycemia
09:45 Management of hypoglycemia
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*Disclaimer*: This video is intended for educational purposes only and while we strive to give the most accurate information, errors may occur. Subsequently, this video should not be a replacement for medical advice.

[@nicolekesler1854]

im a medical student studying for my peds exam, this is amazing!!! keep doing what your doing!!

[@TalaTalksNICU]

That's amazing you're supplementing your reading this way- so glad you're finding these videos helpful! Good luck!

[@saraellis844]

I am a NNP in Ohio and you are my first stop any time I am looking something up. I refer your channel to so many nurses and NNPs! I would love to hear a talk on ABO incompatibility!

[@TalaTalksNICU]

Hello! Thank you so much! I read this comment yesterday evening after SUCH a long day and it gave me so much peace! So thank you!! We made a video on abo stuff (- if you check out the jaundice playlist on home page)? If that doesn’t answer your questions let me know and we’ll wing another one!!

[@saraellis844]

@@TalaTalksNICU I'll blame night shift as the reason I didn't think to look under jaundice first! Lol. Found it, and it was wonderful and helpful as always. Sorry you had such a long day!

[@MoHa-dp3wd]

You do such an amazing job! I love referring a nurses I work with to your channel. Thank you so much for your teams hard work.

[@TalaTalksNICU]

Wow! Thank you so much- for your lovely words, but also for your support :)

[@katielashyro1136]

Great job as always ❤🎉

[@TalaTalksNICU]

THANK YOU!!! XX

[@RK-J10]

Thanks ma'am i am watching from india 😊

[@TalaTalksNICU]

Hi! Thanks for being here!

[@Ruby-wu1hz]

Thanks a lot for your great efforts. It is really beneficial.

[@TalaTalksNICU]

So glad you found it helpful!

[@ابراهيمهواري-س3غ]

Very interesting and very informative as usual Dr. Tala .. I can't wait for the upcoming video

[@TalaTalksNICU]

Thank you so much- and thanks for subscribing too :)

[@adrijanavojinovic5552]

Interesting and systematic approach on everyday issue....very useful video!!! Thank you, dear dr Tala

[@TalaTalksNICU]

Thank you so much for watching and for commenting! I’m so glad you found it interesting :)

[@drheshamelkordi8529]

Thanks Dr Tala

[@TalaTalksNICU]

Thank you for watching!

[@nandaswart4723]

Keep the baby warm and profite lot of skin to skin contact to keep his breading and heartrate stady and stimulate latching

[@TalaTalksNICU]

Yup! All the best ways to prevent low blood sugar! Thank you!

[@BrittleSun]

Great content! Could we have a video about GIR please?

[@TalaTalksNICU]

Hello! We made one! If you go to home page and search for it! Hope that helps!

[@BrittleSun]

@@TalaTalksNICU found it! Thank you for all these excellent and informative videos 🙏

[@sarupal4632]

A video on LATCH score and common lactational issues in mother

[@TalaTalksNICU]

YES!!!! I’m planning on bringing on a lactation specialist for this!! Setting up some interviews!!!! Thank you

[@paediatriciandoctorzahidhu8360]

Does the heal prick method measures while blood or plasma values ?

[@TalaTalksNICU]

Most bedside glucose meters are calibrated to measure whole blood glucose, which can lead to underestimation of true plasma glucose levels, especially in neonates with high hematocrit.

[@tamirattoma11]

How can we proceed after giving glucose bolus? Was glucose iv infusion dose similar for neonate who become hypoglycemic on day one vs day three

[@TalaTalksNICU]

After a bolus- we usually start D10 at a rate appropriate for infant- usually approx 60ml/kg/day.

[@ismailabdat6122]

Morning dr tala, please you can make neonatal hydration for us... Thank you very match

[@TalaTalksNICU]

Yes- I think we need to spend more time on fluid and electrolytes!

[@muradkhamees9251]

Please link for PDF summary

[@TalaTalksNICU]

talatalksnicu.substack.com/subscribe

[@TalaTalksNICU]

talatalksnicu.substack.com/subscribe Sorry! Just saw this comment!

[@khalidfetrat4965]

Mam we start iv fluid even baby is on mother breast milk if yes then it isn’t load on baby or we stop milk 🤔

[@TalaTalksNICU]

We try to avoid starting IVF unless sugars are staying low or baby has symptoms. We'll try keeping baby with mother (glucose gels, supplemental feeds etc)