Hypoglycemia in the neonate

After a brief history of the development of neonatal hypoglycemia, this review emphasizes the current approach to the anticipation, diagnosis, and management of the neonate with a low plasma glucose concentration. Both transient and recurrent or persistent hypoglycemia are discussed. Current techniques for studying the neurophysiologic and endocrine-metabolic effects of significant hypoglycemia provide new approaches for establishing relevant definitions of significant hypoglycemia, its prognosis, and pathogenesis. The inadequacy of glucose oxidase strips for screening, the definition of high risk infants, new definitions for low plasma glucose concentrations and their treatment are discussed. New data concerning the hereditary aspects of hyperinsulinemia, the role of glucose transporters, and the ability of the neonate to respond to significantly low glucose values are presented as well.