Endocrinological aspects at follow-up studies in neonatal hypoglycaemia

Thirty-seven cases of neonatal hypoglycaemia were studied at follow-up at the age of 2 6/12-r 9/12 years. Two of them had had hypoglycaemia were stuafter the newborn period, and another patient died in a hypoglycaemic state following surgery at 10 weeks of age. Twenty-three children had oral glucose tolerance tests and intravenous insulin tolerance tests performed. Diabetic glucose tolerance was noted in 3 children. None of them showed symptoms of diabetes mellitus, neither was there any family history of diabetes. One of these patients had experienced hypoglycaemia after the newborn period and responded with hyperinsulinism during the glucose tolerance test. The other hypoglycaemic patient showed an exaggerated insulin release in response to tolbutamide. Deficient serum cortisol response to insulin-induced hypoglycaemia was demonstrated in 7 patients and 6 of these had concomitant minimal growth hormone response. One of these patients also had a diabetic glucose tolerance. None were of short stature. It is probable that a disturbance in the hypothalamic-pituitary-adrenal axis may contribute to an impaired carbohydrate metabolism in some patients with neonatal hypoglycaemia.