BSPED2022 Oral Communications Oral Communications 5 (9 abstracts)
Evaluation of a low postnatal hypoglycaemia threshold
Chris Worth 1 , Pon Ramya Gokul 1 , Hashim R 1 , Porte H 1 , Sarah Worthington 1 , Mark Dunne 2 , Maria Salomon Estebanez 1 , Mahaveer A 1 & Indi Banerjee 1
1Royal Manchester Children’s Hospital, Manchester, United Kingdom; 2University of Manchester, Manchester, United Kingdom
Background and objective: Neonatal hypoglycemia is common and frequently self-resolving, although rare due to congenital hyperinsulinism are associated with high risk of brain injury. The time period for neonatal hypoglycemia has been described in several studies. It is unknown if low hypoglycemia thresholds (<2.0 mmol/l) lead to missed cases of persistent hypoglycaemia. We aimed to ascertain if lower hypoglycemia threshold risked missing persistent forms of hypoglycemia in a large cohort.
Design and setting: We evaluated glycaemic outcomes of all neonates (17594 glucose measurements) in the postnatal wards of a large maternity center over one year.
Results: A total of 17594 blood glucose levels (48 measurements per day) were undertaken in the postnatal wards from 2749 neonates. For all values, the mean (95% CI) glucose was 5.99 (5.95-6.03) mmol/l with 5th centile and 95th centile values at 2.37 and 11.00 mmol/l respectively. Frequencies for various hypoglycaemia cut-off levels ( mmol/l) were: <3.0 (10.1%); <2.6 (5.8%); <2.2 (2.9%); and <2.0 (2.2%). Blood glucose <2.0 mmol/l occurred in 239 neonates. In all neonates, glucose levels improved on retesting [1.50 (1.45-1.55) to 3.16 (3.05-3.26), p<0.001]. In 239 neonates with hypoglycaemia (glucose <2.0 mmol/l), higher mean (95%CI) glucose levels [1.61 (1.57-1.65) vs 1.05 (0.93-1.17)] were associated with lower risk of re- admission [p <0.001]. Follow-up assessments were available for 39 neonates and none were readmitted with hypoglycemia later.
Conclusion: Hypoglycaemia is frequent in neonates with point of care testing detecting blood glucose less than 2.0 mmol/l in just over 2%. A low hypoglycaemia threshold of 2.0 mmol/l in the early period, was not associated with later life persistent hypoglycaemia. The low postnatal hypoglycaemic threshold in current practice can be continued, although careful monitoring is required due to the risk of escalation to persistent hypoglyaemia due to disorders such as Congenital hyperinsulinism. Our findings demonstrate the relative utility of carefully monitored low postnatal hypoglycemia threshold.
Volume 85
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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