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American Academy of Pediatrics
Article

Glucose Homeostasis in Newborns: An Endocrinology Perspective

Emir Tas, Luigi Garibaldi and Radhika Muzumdar
NeoReviews January 2020, 21 (1) e14-e29; DOI: https://doi.org/10.1542/neo.21-1-e14
Emir Tas
*Division of Endocrinology and Diabetes, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, AR
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Luigi Garibaldi
†Division of Endocrinology, Department of Pediatrics, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
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Radhika Muzumdar
†Division of Endocrinology, Department of Pediatrics, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
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  • Abbreviations:
    ACTH:
    adrenocorticotropic hormone
    ATP:
    adenosine triphosphate
    CNS:
    central nervous system
    DEND:
    developmental delay, epilepsy, and neonatal diabetes
    FFA:
    free fatty acid
    GCK:
    glucokinase
    GDH:
    glutamate dehydrogenase
    GH:
    growth hormone
    GIR:
    glucose infusion rate
    HI/HA:
    hyperinsulinism/hyperammonemia
    IGF-1:
    insulinlike growth factor 1
    IGFBP-3:
    IGF-binding protein 3
    IUGR:
    intrauterine growth restriction
    LGA:
    large for gestational age
    NDM:
    neonatal diabetes mellitus
    PES:
    Pediatric Endocrine Society
    PG:
    plasma glucose
    PNDM:
    permanent neonatal diabetes mellitus
    SCHAD:
    short-chain L-3-hydroxyacyl-CoA dehydrogenase
    SGA:
    small for gestational age
    TCA:
    tricarboxylic acid
    TNDM:
    transient neonatal diabetes mellitus
    VLBW:
    very low birthweight
  • Abstract

    Physiologic adaptations in the postnatal period, along with gradual establishment of enteral feeding, help maintain plasma glucose concentrations in the neonatal period. The definition of normal plasma glucose in the neonatal period has been a subject of debate because of a lack of evidence linking a set plasma or blood glucose concentration to clinical symptoms or predictors of short- and long-term outcomes. However, there is consensus that maintaining plasma glucose in the normal range for age is important to prevent immediate and long-term neurodevelopmental consequences of hypoglycemia or hyperglycemia. The specific management strategy for abnormal glucose levels in neonates depends on the underlying etiology, and interventions could include nutritional changes, medications, hormone therapy, or even surgery. Here, we will review the physiological processes that help maintain plasma glucose in newborns and discuss the approach to a newborn with disordered glucose homeostasis, with an emphasis on the endocrine basis of abnormal glucose homeostasis.

    • Copyright © 2020 by the American Academy of Pediatrics

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    Glucose Homeostasis in Newborns: An Endocrinology Perspective
    Emir Tas, Luigi Garibaldi, Radhika Muzumdar
    NeoReviews Jan 2020, 21 (1) e14-e29; DOI: 10.1542/neo.21-1-e14

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    Glucose Homeostasis in Newborns: An Endocrinology Perspective
    Emir Tas, Luigi Garibaldi, Radhika Muzumdar
    NeoReviews Jan 2020, 21 (1) e14-e29; DOI: 10.1542/neo.21-1-e14
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      • Abstract
      • Education Gap
      • Objectives
      • Introduction
      • Physiology of Glucose Homeostasis in the Newborn
      • Hypoglycemia in the Newborn
      • Hyperglycemia
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