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Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology
Hyperglycemia is common in newborns requiring intensive care, particularly in preterm infants, in sepsis and following perinatal hypoxia. The clinical significance, and optimal intervention strategy varies with context, but hyperglycaemia is associated with increased mortality and morbidity. The lim...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8333866/ https://www.ncbi.nlm.nih.gov/pubmed/34368024 http://dx.doi.org/10.3389/fped.2021.641306 |
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author | Beardsall, Kathryn |
author_facet | Beardsall, Kathryn |
author_sort | Beardsall, Kathryn |
collection | PubMed |
description | Hyperglycemia is common in newborns requiring intensive care, particularly in preterm infants, in sepsis and following perinatal hypoxia. The clinical significance, and optimal intervention strategy varies with context, but hyperglycaemia is associated with increased mortality and morbidity. The limited evidence for optimal clinical targets mean controversy remains regarding thresholds for intervention, and management strategies. The first consideration in the management of hyperglycaemia must be to ascertain potentially treatable causes. Calculation of the glucose infusion rate (GIR) to insure this is not excessive, is critical but the use of insulin is often helpful in the extremely preterm infant, but is associated with an increased risk of hypoglycaemia. The use of continuous glucose monitoring (CGM) has recently been demonstrated to be helpful in targeting glucose control, and reducing the risk from hypoglycaemia in the preterm infant. Its use in other at risk infants remains to be explored, and further studies are needed to provide a better understanding of the optimal glucose targets for different clinical conditions. In the future the combination of CGM and advances in computer algorithms, to provide intelligent closed loop systems, could allow a safer and more personalized approached to management. |
format | Online Article Text |
id | pubmed-8333866 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83338662021-08-05 Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology Beardsall, Kathryn Front Pediatr Pediatrics Hyperglycemia is common in newborns requiring intensive care, particularly in preterm infants, in sepsis and following perinatal hypoxia. The clinical significance, and optimal intervention strategy varies with context, but hyperglycaemia is associated with increased mortality and morbidity. The limited evidence for optimal clinical targets mean controversy remains regarding thresholds for intervention, and management strategies. The first consideration in the management of hyperglycaemia must be to ascertain potentially treatable causes. Calculation of the glucose infusion rate (GIR) to insure this is not excessive, is critical but the use of insulin is often helpful in the extremely preterm infant, but is associated with an increased risk of hypoglycaemia. The use of continuous glucose monitoring (CGM) has recently been demonstrated to be helpful in targeting glucose control, and reducing the risk from hypoglycaemia in the preterm infant. Its use in other at risk infants remains to be explored, and further studies are needed to provide a better understanding of the optimal glucose targets for different clinical conditions. In the future the combination of CGM and advances in computer algorithms, to provide intelligent closed loop systems, could allow a safer and more personalized approached to management. Frontiers Media S.A. 2021-07-21 /pmc/articles/PMC8333866/ /pubmed/34368024 http://dx.doi.org/10.3389/fped.2021.641306 Text en Copyright © 2021 Beardsall. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Beardsall, Kathryn Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology |
title | Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology |
title_full | Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology |
title_fullStr | Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology |
title_full_unstemmed | Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology |
title_short | Hyperglycaemia in the Newborn Infant. Physiology Verses Pathology |
title_sort | hyperglycaemia in the newborn infant. physiology verses pathology |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8333866/ https://www.ncbi.nlm.nih.gov/pubmed/34368024 http://dx.doi.org/10.3389/fped.2021.641306 |
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