Neonatal Hypoglycemia: Causes, Symptoms, PROGNOSIS

How LOW do sugars go in babies? What CAUSES hypoglycemia? WHEN do we have to treat and WHY? How do we MEASURE sugars? Is there a difference in sending the glucose to the lab or checking it ad bedside? Which infants are at risk for low sugars? Learn all this and more in PART I of our 2 part series on newborn hypoglycemia.
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:
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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References:
downloads.aap....
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.
Congenital Hyperinsulinaemic Hypoglycaemia-A Review and Case Presentation - Scientific Figure on ResearchGate. Available from: www.researchga...
: Hufnagel A, Dearden L, Fernandez-Twinn DS, Ozanne SE. Programming of cardiometabolic health: the role of maternal and fetal hyperinsulinaemia. Journal of Endocrinology. 2022;253(2):R47-R63. doi:10.1530/JOE-21-0332
doi.org/10.100...
Edwards T, Alsweiler JM, Gamble GD, Griffith R, Lin L, McKinlay CJD, Rogers JA, Thompson B, Wouldes TA, Harding JE. Neurocognitive Outcomes at Age 2 Years After Neonatal Hypoglycemia in a Cohort of Participants From the hPOD Randomized Trial. JAMA Netw Open. 2022 Oct 3;5(10):e2235989. doi: 10.1001/jamanetworkopen.2022.35989. PMID: 36219444; PMCID: PMC9554702
Brooks D, Slaughter JC, Nichols JH, Gregory JM. Reliability of Handheld Blood Glucose Monitors in Neonates: Trustworthy Arterial Readings but Capillary Results Warrant Caution for Hypoglycemia. Journal of Diabetes Science and Technology. 2023;0(0). doi:10.1177/19322968231207861
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**TIMESTAMPS**
00:32 What is this video about?
01:16 Why is hypoglycemia bad?
06:11 What causes hypoglycemia?
13:00 Symptoms of hypoglycemia
15:07 How do we measure glucose levels?
20:40 Homework assignment
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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.

[@HarleyMom223]

Love listening to everything you discuss ✨✨ you make it easy to understand 😊 Thankyou!!

[@TalaTalksNICU]

Can’t tell you how happy it makes us to know our videos make things easier!!! Thank you thank you!!!

[@HarleyMom223]

@@TalaTalksNICU I love all your NICU content!! Because of you and your knowledge I was able to pass my Neonatal RNC exam 🤗

[@TalaTalksNICU]

Oh yay!!!!! Congratulations! Was definitely not all our stuff- I bet you worked super hard too! But thank you! Made my day :)

[@TalaTalksNICU]

Thank you and GO you!

[@HarleyMom223]

@@TalaTalksNICU Thankyou. !!! It was a lot of studying and hard work 🤗but proud of that accomplishment!!🩷 Thankyou!!

[@PlayStore500-q9i]

I m 1st year resident paed from india. Your videos are so good n so informative Thank you for sharing with all I would request you to start series on PICU as well Have recommended your channel to my co residents.

[@TalaTalksNICU]

Hello! We’re so happy you’re finding these videos helpful - and thank you so much for sharing and giving that support! I’m a neonatologist- so I wouldn’t feel great about giving “expert” advice in a field I’m not an expert in!!! I’m sure there are lots of great videos out there!

[@caitlynnmae2475]

This is a good thumbnail design - much improved 👌🙌

[@TalaTalksNICU]

Haha! Good! We’re trying!!!! Arianna and I both like the medical teaching aspects so all this other tech stuff has been a learning curve!!!

[@sedofsedof6435]

Thanks Dr tala

[@TalaTalksNICU]

Thank you for your support!

[@nisreenyousif9697]

Thank you Tala Where is the next video of hypoglycemia definition and management?

[@TalaTalksNICU]

Next week- we publish videos every two weeks because they’re all so time consuming! (So Monday 16th Sept for that one!)

[@khairyelwerfeli]

As expected… always sounds easy ❤️ Waiting for the next Vid

[@TalaTalksNICU]

Thank so much! Biggest compliment to think something sounds easy

[@Chris-di6nl]

Homework: 1. 5 signs of hypoglycemia Jittery, tachypnea, irritability (early) seizures, lethargy (late) 2. IDM have hypoglycemia because they are getting a large amount of sugar diffused from their mom and when that supply is discontinued after the cord is cut, the pancreas may still be secreting large amounts of insulin that will tank that high amount of sugar 3. We care about hypoglycemia in the newborn because glucose is the primary fuel for the brain which dictates other systems, and extended periods of hypoglycemia can result in unfavorable developmental outcomes Question!! I don't understand how bedside sugar checks are considered "plasma" samples. Doesn't the lab centrifuge and separate the blood cells from plasma? I think its a totally foreign concept to me. In my NICU we get blood sugar within hour after birth and usually intervene in the form of D10 boluses then infusion just based off a single heelstick; rarely sweetcheeks, othertimes feeding (depending on the value ofcourse) I recall many of our cooling babies and babies with HIE often have trouble with glucose regulation but I never got the change to understand exactly why. Can you cover that in the next video? Thanks Teach!!

[@TalaTalksNICU]

Oh WOW!!! I want to send you a gold star! Well done!!! To check the blood glucose in whole blood the blood cells need to actually be broken down (so also checking fluid in blood cells for concentration ). The lab does this. We do something very similar in our NICUs too. We touch on HIE in next video - out on Monday- but the key thing to know is lots of bad things happen with HIE. So many hormones and processes begin in brain- so often it all goes abnormal under stress. Often sugars go up at start because of baby’s perinatal stress, then they go down because baby needs sugar, before they finally stabilize! Thank you thank you for watching and your enthusiasm!

[@drheshamelkordi8529]

A lot of thanks, Dr Tala

[@TalaTalksNICU]

A lot of thanks to you for being here :)

[@edmonduku9330]

Thank for the well explained video 🇸🇸

[@TalaTalksNICU]

So glad you liked it! Thanks for writing!

[@griffinanasi6646]

The pdf newsletter kindly.. Consider pain management in neonates video Thanks

[@TalaTalksNICU]

URGH!!!! I’m so sorry!!!! Still haven’t done this! I promise by the need of the year!!!

[@ismailabdat6122]

Thank you

[@TalaTalksNICU]

Thank you for being here :)

[@madanat1000]

Wonderful

[@TalaTalksNICU]

Thank you! Next one more helpful!

[@muradkhamees9251]

Thanks Dr. Tala I have a question What are best value Glucose infusion rate for term low birth weight very low birth weight extremely low birth weight ang IUGR?

[@TalaTalksNICU]

Really we don’t want to go below a GIR of 4 because that’s what brain needs. A lot of these babies have issues with HYPERglycemia after birth (ELBW) so often we start close to that. The LBW babies we may start higher ~ 5 especially if they have hypoglycemia. Does that make sense? We cover this more in tomorrows lecture!!!!

[@docvaruna]

1. 5sx Jitterness,irritability, poor feed,lethargy,seizures 2. IDM baby Transient increase in insulin levels 3. Why do we care about hypoglycemia Increased risk of neurosensory impairment at later life.

[@TalaTalksNICU]

Yes!!! Amazing!