Exploring the long-term impacts of neonatal hypoglycemia to determine a safe threshold for glucose concentrations

作者：Meena Garg, Sherin U. Devaskar · 发表于：European Journal of Pediatrics · 年份：2025 · DOI：10.1007/s00431-025-06082-z · 被引用次数：9 · 研究领域：Hyperglycemia and glycemic control in critically ill and hospitalized patients、Neonatal and fetal brain pathology、Diabetes Management and Research

Hypoglycemia and impaired metabolic transition are frequently observed in neonates during the first 24-48 h after birth [1, 2]. Severe (< 36 mg/dL or 2 mmol/L) and recurrent (3 or more episodes) hypoglycemia can cause neurological injury and developmental delays. The ambiguity regarding a threshold blood glucose concentration remains due to differing values proposed by various professional organizations. This poses a challenge in diagnosing neonatal hypoglycemia in addition to using a single blood glucose value, which in itself is not entirely reflective of various key molecular processes uncovered by in vitro or pre-clinical studies. The symptoms of hypoglycemia can also be present in conditions other than hypoglycemia, e.g., sepsis and polycythemia, and in many cases, hypoglycemia is clinically unrecognized. Therefore, early screening of at-risk and otherwise healthy-appearing neonates is essential. Continuous glucose monitoring and early interventions such as glucose gel, breast and formula feeding, and intravenous glucose administration are utilized to prevent long-term neurological impairments. However, the safe limits of serum glucose that will prevent neuroglycopenia and neural injury are elusive. The impact of early screening and available therapies on neurodevelopmental outcomes remains uncertain due to the absence of a robust clinical design and combining all causes of neonatal hypoglycemia without making further distinctions from other conditions. This review highl...