Long-term outcomes of neonatal hypoglycemia

Article

A session at the virtual Scientific Sessions for the American Diabetes Association examined the potential long-term outcomes for a child who experiences neonatal hypoglycemia.

Neonatal hypoglycemia is a common occurrence in newborns and treatment can help reduce the risk of brain injury due to severe, prolonged, or recurrent hypoglycemia. A presentation at the 81st virtual Scientific Sessions for the American Diabetes Association examined the long-term outcomes of neonatal hypoglycemia. Raghavendra Rao, MD, a professor of pediatrics and director of the division of neonatology at the University of Minnesota in Minneapolis, discussed whether newborn brains were more vulnerable than adult brains during hypoglycemia as well as well the impact of rapid correction on brain injury.

In a study that used rats, investigators found that hypoglycemia led to injury in the areas of the brain that govern emotion, attention and learning as well as cognitive function. In the adult rats, it led to problems with the areas that involve visuospatial information processing and the ability to smell. In cases of acute hypoglycemia, the brain will initially use glucose and then move onto other substrates. If those substrates are exhausted, there is energy failure which can lead to brain injury. Although dextrose administration can lead to improved metabolite levels, some metabolites such as aspartate and glutamine do not easily recover after treatment. Another test in rhesus monkeys included monkeys that had different durations of hypoglycemia including 6 hours and 10 hours. In this study, the investigators found that both cognitive and behavioral performance were unaffected in those with 6 hours of hypoglycemia. However, there were training difficulties noted in 50% of the monkeys who had experienced 10 hours. No memory or personality differences were noted in either group.

The CHYLD study from New Zealand involved 604 preterm and term at-risk infants who received glucose monitoring for the first 7 days. The children were given a neurodevelopmental assessment at age 2 and 4.5 years. There was no link between neonatal hypoglycemia and neurosensory impairment at either assessment. However, infants with hypoglycemia were found to have more executive dysfunction, impaired visual-motor integration, and greater risk of severe and recurrent hypoglycemia at the 4.5 year assessment.

Rao also discussed a study in rats that compared using different doses of dextrose, 10% versus 50%, to end acute hypoglycemia. The investigators in this study found that the use of the 50% dextrose solution was linked to a higher risk of neuronal injury.

This article was originally published on Contemporary Pediatrics®.

Reference

1. Rao R. Long-term outcomes of neonatal hypoglycemia-clinical lessons from the lab. American Diabetes Association Scientific Sessions 2021; June 28, 2021; virtual. Accessed June 28, 2021.

Related Videos
Addressing maternal health inequities: Insights from CDC's Wanda Barfield | Image Credit: cdc.gov
Addressing racial and ethnic disparities in brachial plexus birth Injury | Image Credit: shrinerschildrens.org
Innovations in prenatal care: Insights from ACOG 2024 | Image Credit:  uofmhealth.org.
The impact of smoking cessation on pregnancy outcomes | Image Credit: rwjmg.rwjms.rutgers.edu
Maximizing maternal health: The impact of exercise during pregnancy | Image Credit: cedars-sinai.org
The importance of nipocalimab’s FTD against FNAIT | Image Credit:  linkedin.com
Fertility treatment challenges for Muslim women during fasting holidays | Image Credit: rmanetwork.com
CDC estimates of maternal mortality found overestimated | Image Credit: rwjms.rutgers.edu.
Study unveils maternal mortality tracking trends | Image Credit: obhg.com
Related Content
© 2024 MJH Life Sciences

All rights reserved.