RISKS for Infants of Diabetic Mother: HYPOGLYCEMIA and what else???!!

[@Ourlittlefunnyfarm]

I work in a small community hospital as an LDRP nurse and we seem to be seeing more and more pregnant women with uncontrolled diabetes. This was so helpful to explain the “why” of a number of issues we see with these babies. I appreciate your ability to convey information in easy to understand terms.

[@TalaTalksNICU]

Hello- we're so glad this has been helpful all! Thanks so much for taking the time let us know. Also- so impressive you're looking for education in alternative places- on like a NICU youtube channel. Says a lot more about you than about us!!! Thank you :)

[@DeborahGeilich]

Good morning from Germany!!! THANK YOU SO MUCH FOR ALL YOUR EFFORT and time to produce these lovely videos. I am studying for my Neonatology Boards and your videos help me SO MUCH for it!! Cheers

[@TalaTalksNICU]

You're very welcome! WISHING you so much luck on your boards XX

[@skawagu2]

It was one of the best videos I've ever watched during med school. Thank you so much!

[@TalaTalksNICU]

Wow! Thank you! That comment made our day!!!! Please check out the other ones and let us know if there are any videos you’d be interested in?!

[@zafariqbalbhatti2788]

Grt presentation

[@collinsobonyo8764]

Your lectures are a gem!!

[@TalaTalksNICU]

Thank you so much!!!

[@drheshamelkordi8529]

Fantastic as usual

[@TalaTalksNICU]

Loving all your support! Thank you!!!!

[@Dibberntv]

This was so informative from a respiratory standpoint!! This week alone I had two 35 weekers come out in respiratory distress one needed needle aspirated and surfed. Thanks for helping understand why!

[@TalaTalksNICU]

Crazy how they come in pairs and theres- always! So glad you found this helpful!

[@Namronnnn45]

Thanks for this. Take my OB final in 2 weeks. lets go!!

[@TalaTalksNICU]

Oh yay! Good luck!!!! Thanks for writing to us!!!

[@mercyagoh-dorman258]

Clear, concise and very informative. Thank you

[@TalaTalksNICU]

Thanks so much Mercy for your lovely words. We really appreciate you being here :)

[@lgarcia8784]

This was soooooooooooo helpful!

[@TalaTalksNICU]

Sooooooooo happy you found it helpful!! Ha! Thanks for being here :)

[@fantasticweb6384]

Dear Dr. Tala ... Could you please let me know which playlist this video belongs to? Also, are there any videos that are not currently included in a playlist? I plan to watch all your videos one playlist at a time, and I don’t want to miss any of your amazing content. If there are any videos not yet organized into playlists, I would greatly appreciate it if you could add them to one. Thank you for your hard work and incredible videos!

[@TalaTalksNICU]

Hello! I think this is on the fluids and electrolytes play-list. But i you go to theb home page- you can find all the videos! Thanks for being ehre!

[@fantasticweb6384]

@TalaTalksNICU Not quite, but I really appreciate your effort. Thanks again, and I hope you’re doing well!

[@zafariqbalbhatti2788]

Really grt grt ; well explained

[@TalaTalksNICU]

Thanks!

[@HussnainG-pd4sx]

Thank you Dr tala for explaining ❤

[@TalaTalksNICU]

My pleasure 😊thank you for being here!

[@kebedealemu8859]

Thank you doctor for your explanation.

[@TalaTalksNICU]

Thank you for watching Kebede!

[@sifnamoljoseph85]

good presentation

[@TalaTalksNICU]

Thank you!!!!

[@mwewachansa9959]

Amazing presentation , i enjoy your lectures. Watching you from zambia-AFRICA

[@TalaTalksNICU]

That makes us so happy! Thank you for watching and thank you for letting us know where you are! We imagine beautiful views from your NICU!!

[@lvillarreal8865]

Awesome as always Dr. Tala!!!

[@TalaTalksNICU]

We always love your comments! Thanks so much for your continued support :)

[@marwaelfar7880]

Amazing videos....i do recommend

[@TalaTalksNICU]

Thank you- we appreciate your support!

[@doaamohamed589]

CAN WE HAVE VEDIO FOR HYPOGLYCEMIA APROACH THANK YOU SO MUCH FOR YOUR AMAZING EXIPLANATION

[@TalaTalksNICU]

Ok I think we’ll try to do this one next!!! It’s time!!!!! Thanks for being here!

[@drazam325]

Very commanding talk Dr Tala

[@TalaTalksNICU]

Thank you so much for continuing to watch our channel!!! We appreciate your support :)

[@latifamohammed9849]

Very useful information

[@TalaTalksNICU]

So glad you think so- thank you!

[@joemygawd]

Wow that was a lot. Nicely done!

[@TalaTalksNICU]

Thank you Joey- and again- thanks for subscribing!

[@MamaGiegie]

Thank you very much for this wonderful discussion. This is really a great help to me. Love the way you expound the topic/s.

[@TalaTalksNICU]

We're so happy you found this video helpful. Thank you so much for taking the time to write to us :)

[@bernadetteanntabdi2545]

Thank you Dr. Tala! God Bless you!

[@TalaTalksNICU]

Thank you for the lovely sentiment Bernadette! We really appreciate you being here :)

[@asmamajeed7551]

Very veryy well explained

[@TalaTalksNICU]

Thank you so much :)

[@aljoharaha7807]

Blesss u 😊

[@TalaTalksNICU]

Thank you :))))

[@edmonduku9330]

well explained

[@TalaTalksNICU]

Thank you so much!!

[@amreshyadav2758]

could you make a video regarding drawbacks of c- section.. if you already has one, please provide the link. thanks

[@TalaTalksNICU]

Hello! We haven’t made a C-section video- I’m assuming you meant from a neonatal standpoint! Honestly when OBs are doing a C-section it’s normally to save the baby or save the mama (or better for either for some reason) and so most of the time we have to deal with it!!!!

[@eyadalrefai6438]

Very nice presentation 👍👍 Thank you so much

[@TalaTalksNICU]

Thank you so much for watching and for taking the time to comment Eyad :)

[@syedmuzaffar2966]

Great very informative

[@TalaTalksNICU]

We're so glad you found it informative. Thanks so much for being here Syed :)

[@minhajtabish]

Amazing 👏👏

[@TalaTalksNICU]

Thank you so much! And thanks so much for subscribing Minhaj :)

[@jellymaedesaca8460]

Very informative Doc. Thank you so much for this:)

[@TalaTalksNICU]

Thank you for watching and taking the time to thank us!!

[@mahaqazzaz2531]

Thank you very much

[@TalaTalksNICU]

Thank you so much for watching and for taking the time to comment :)

[@ngawanajerydel8571]

thank you

[@TalaTalksNICU]

Thank you so much for watching (and for subscribing!)!!

[@wparsa]

Thank you doctor

[@TalaTalksNICU]

Thank you so much for watching and for taking the time to comment :)

[@scratchopoly7161]

Thank you 🙏🏼

[@TalaTalksNICU]

You're so welcome- thanks for being here :)

[@TheTheGhost14]

Thank you!

[@TalaTalksNICU]

Thank you so much for watching and commenting :)

[@syedmuzaffar2966]

Could you please give presentation on prophylaxis fluconazole in extreme low birth weight baby

[@TalaTalksNICU]

Yes! This is a great idea for a quick video! Essentially- it is encouraged in units that have more fungal infections. We can definitely cover that. Thanks for that idea!!!

[@cecileaglae7643]

Thanks

[@TalaTalksNICU]

Thank you for watching :)

[@cecileaglae7643]

Hi Dr Tala, Is it possible to do videos on osteopenia in preterm and at what stage does low phosphate is concern a GI issue, chest and abdominal X-rays please.All your videos are very informative.

[@TalaTalksNICU]

Hi Cecile- this is a great idea. It's funny- when I was in residency- we had so many issues with osteopenia (and alkaline phosphatase >1000, with poor little babies getting fractures)- now we're all so much better with nutrition, and we have much better choices, that it's much rarer. But it is a very important topic- especially since we're still on a fluid and electrolyte kick!

[@sumathybalaji5252]

Nice video

[@TalaTalksNICU]

We're so glad you liked it Sumathy! Thanks for letting us know :)

[@AshishPriyadarshi-jj4ib]

Can you cover eclampsia and preeclampsia?

[@TalaTalksNICU]

Yes! We’re planning on this video soon! Thanks so much for the suggestion!

[@freedaboyoung3722]

OMG I wasn't aware insulin can't cross the placenta. I kept thinking it was maternal insulin that accumulated in the child (baby+ mom's insulin maybe had an added action) and needed a day or two to be used up and then the baby would be okay. Thank you for this really informative video!

[@TalaTalksNICU]

So glad it helped! Love those a- ha moments!!!

[@freedaboyoung3722]

@@TalaTalksNICU yes!!!

[@madanat1000]

Thank you so much for the rich and smooth videos you do on this channel. Back in the late 90s while going through my neonatology training at LLUCH , we were instructed to check G.S q 15 minutes in the first 4 hours , especially in mother with poorly controlled blood sugar . i wonder if you can give standard protocol for such situation ? currently i go with q 1/2 hour in the first 4 hours ! thanks

[@TalaTalksNICU]

Hello! So glad you like the videos. So generally the only babies we check for sugars are the ones at risk (SGA, LGA, IDM and premature). Protocols are pretty much set by different hospitals. Generally, the first sugar is checked soon after birth ~1 hr. Even the threshold for hypoglycemia is different in different hospitals (somewhere around < 45). If sugars are normal then they're checked qAC for 12- 24 hrs. If abnormal- then a different pathway followed- we use glucose gel if needed. Does that help?!

[@cecileaglae7643]

Hi Dr Tala Is it possible to explain the pathophysiology of CHI please.

[@TalaTalksNICU]

Hello!I'm assuming you're referring to congenital hyperinsulinism? (This used to be called nesidioblastosis)- and it's basically a 'tumor' of the islet cells in the pancreas- that continuously over-secret insulin. (So unlike the normal IDM neonate- the hyperinsulism is transient- with CHI- the high insulin levels never go away). Many of these are genetic in origin. Ultimately they are treated with aggressive feeds (if milder), medications and sometimes surgery- where a large part of the pancreas is removed. (We will cover a video on hypoglycemia at some point!) Thanks foe asking this question :)

[@mostafaabuollo9479]

thanks alot but why you dont talk about PpHn in idm

[@TalaTalksNICU]

Yes- probably should have emphasized that more. Definitely a higher risk of developing PPHN (RDS, perinatal depression, septal hypertrophy). We look back at so many of these videos and think how we could have improved upon them! We're constantly trying!! Thank you!

[@shabirdraayatmalla9]

Excellent work...But images and graphics will make presentation much tastier....Anyway excellent job

[@TalaTalksNICU]

You are so right! We made this video a couple of years ago and have since realized how we need to be including so many more pictures and graphics. Slightly improving but we still have a ways to go!!!! Thank you!

[@beverlyreyes7675]

Love this easy explanation. Will surely share this video to my nicu nurses 👍

[@TalaTalksNICU]

Thank you so much Beverly! You've been such a loyal supporter :)

[@freedaboyoung3722]

Dr Tala, when we monitor BSR in an IDM, do we screen for the first 48 hours at hours 0, 2, 4, 6, 12, 24, and 48? Is this the recommendation? We follow this, but sometimes we also follow 2 hourly monitoring (and then relax to 4 hourly blood sugars if they are satisfactory) so I don't know why we have different approaches? Thank you, Dr Tala

[@TalaTalksNICU]

Hello! Excellent question! Each hospital has slightly different protocols- so there really isn’t a standard. Generally sugars are checked before feedings (so we have the lowest possible sugars). So normally this is ~ q 3 hrs. There is so much controversy about which sugar levels are acceptable and what to do about it that I’m guessing every protocol is within standard of care. I wouldn’t be surprised if we all decrease how often we’re checking sugars in asymptomatic neonates in the near future.

[@rasoulhoma8007]

👌👏

[@TalaTalksNICU]

Thank you!!!

[@cecileaglae7643]

Sorry l meant consider a Gl issue.

[@TalaTalksNICU]

Yes- this is great too- we're going to start a 'symptom' type series- so we'll cover this then too. Thanks for being here!