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Hyperinsulinaemic hypoglycaemia in small for dates babies
J E Collins1, J V Leonard, D Teale
1Department of Child Health, Institute of Child Health, London.
Insights
Hyperinsulinism is a common cause of hypoglycemia in small for dates infants. Recognizing this condition is crucial for timely treatment and preventing long-term complications in newborns.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
Background:
- Small for dates infants are at increased risk for metabolic disturbances.
- Hypoglycemia is a frequent complication in this vulnerable population.
Purpose of the Study:
- To investigate the incidence and characteristics of hyperinsulinism in small for dates infants.
- To determine the recurrence of hypoglycemia in infants with and without hyperinsulinism.
Main Methods:
- Prospective measurement of blood glucose concentrations in 27 small for dates infants within 48 hours of birth.
- Assessment of plasma insulin and free fatty acid levels.
- Monitoring carbohydrate intake and recurrence of hypoglycemia.
Main Results:
- 10 out of 27 infants developed hypoglycemia.
- Five infants with hypoglycemia had inappropriately high plasma insulin levels, indicative of hyperinsulinism.
- These five infants also showed lower plasma free fatty acids and higher carbohydrate intake.
- Recurrent hypoglycemia occurred in 4 of 5 hyperinsulinaemic infants, but none of the non-hyperinsulinaemic infants.
Conclusions:
- Hyperinsulinism is a significant and common cause of hypoglycemia in small for dates infants.
- Early recognition of hyperinsulinism is essential due to the high likelihood of hypoglycemia recurrence.
- Prompt and appropriate treatment is necessary to prevent potential long-term sequelae in affected newborns.
Abstract:
Blood glucose concentrations were measured prospectively in 27 small for dates infants in the first 48 hours after birth: 10 infants became hypoglycaemic. Of these, five had inappropriately raised plasma insulin concentrations. Plasma free fatty acids were lower and carbohydrate intake higher in these five infants, further supporting the diagnosis of hyperinsulinism. The hypoglycaemia recurred in four of the five hyperinsulinaemic infants, but in none of those who were not hyperinsulinaemic. Hyperinsulinism is common in small for dates babies. It is important to recognise this because hypoglycaemia is likely to recur and appropriate treatment is needed to prevent long term sequelae.