Hyperglycemia refers to a serum glucose concentration> 150 mg / dl (> 8.3 mmmol / l).
The most common cause of neonatal hyperglycemia
Hyperglycemia refers to a serum glucose concentration> 150 mg / dl (> 8.3 mmmol / l). The most common cause of neonatal hyperglycemia is Iatrogenic The iatrogenic causes include too rapid infusion of glucose, often in children with very low birth weight (<1.5 kg) in the first days of life. The other significant cause is physiological stress by surgical intervention, hypoxia, respiratory distress syndrome or sepsis; the fungal sepsis represents a particular risk. In premature infants a partial disruption of the conversion of proinsulin to insulin and relative insulin resistance can lead to hyperglycaemia. In addition, the transient neonatal diabetes is a rare self-limiting cause that is commonly observed in SGA infants; and treatment with corticosteroids may cause a transient hyperglycemia. Hyperglycemia, although rarer than the hypoglycemia, but it is an important disease because it results in higher morbidity and mortality due to the underlying cause. Symptoms and discomfort symptoms and complaints of neonatal hyperglycemia are those of the underlying disease. Diagnostic serum glucose analysis Diagnosis of neonatal hyperglycemia is done by serum glucose tests. Other laboratory abnormalities may be glucosuria and a significant hyperosmolarity of the serum. Treatment minimizing the I.V. Dextrose in concentration, frequency, or both in some cases i.v. Insulin for the treatment of iatrogenic hyperglycemia should be reduced, the concentration (for example from 10% to 5%.) Or the quantity of infused glucose; persistent hyperglycemia at low infusion rates (z. B. 4 mg / kg / min) can indicate a relative insulin deficiency, or insulin resistance. The treatment of other causes of rapid-acting insulin. One approach is to add fast acting insulin to a 10% glucose solution at a uniform rate of 0.01-0.1 I.E./kg/h and to titrate the infusion rate until the glucose level has been corrected. Alternatively, the insulin own 10% glucose solution can be added, which is then placed simultaneously with the actual infusion so that the amount of insulin can be adjusted in each case without changing the total infusion volume. It can not be predicted how quickly the hyperglycemia responsive to the insulin. Therefore, it is important to determine serum glucose levels regularly and carefully adjust the insulin fusion rate. When transient neonatal diabetes mellitus hyperglycemia should until normalization, be taken as a rule within a few weeks, the blood sugar levels and a fluid balance. Lost by osmotic diuresis fluid and electrolytes must be replaced.