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Neonatal hypoglycemia

1.Transient (most common)


2.Persistenet (less common)

Transient neonatal hypoglycemia


is usually detected by screening protocols
established for high-risk infants.
A. High-risk conditions associated
with inadequate substrate include
1.prematurity
2.history of perinatal asphyxia or fetal
distress
3.small-for-gestational age (SGA)
4. large-for-gestational age (LGA) infants.

b. High-risk conditions
associated with inappropriate
hyperinsulinism include
1.

SGA infants

2.infants of diabetic mothers.

2. Persistent neonatal hypoglycemia


is defined as hypoglycemia that persists for
longer
than 3 days.
a. Hyperinsulinism, which may be caused by:
1. Islet cell hyperplasia (nesidioblastosis)
2. Beckwith-Wiedemann syndrome: Patients are
LGA and present with visceromegaly,
hemihypertrophy, macroglossia, umbilical hernias,
and distinctive ear creases.

b. Hereditary defects
in carbohydrate metabolism (e.g.,
glycogen storage disease type I and
galactosemia)
amino acid metabolism (e.g., maple
syrup urine disease, methylmalonic
acidemia and tyrosinemia)

c. Hormone deficiencies,
including
growth hormone deficiency
Cortisol deficiency. (Pearl: Congenital
hypopituitarism should be suspected
in the neonate who presents with
hypoglycemia, microphallus, and
midline defects such as a cleft
palate.)