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- 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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