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What Causes Hypoglycemia In New Born?

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Posted on Thu, 4 Jun 2015
Question: My granddaughter was born early March and within a day started having issues with blood sugar levels. The normal procedures were done like IV and monitoring with more feedings of breast milk. The sugar levels increased but would fall as soon as IV usage was reduced. She was transferred to the Children's hospital and stayed there for a couple weeks. While there with constant monitoring, they had her on medication to raise her sugar levels. This worked but during the same time the reading were fluctuating. She finally was released having the condition under control somewhat and still having to take medication. My daughter has to continually monitor her blood and with keeping with the process the babies sugar level was decreasing little by little and was ever fluctuating in that they would be in low numbers one minute and over 100’s a few minutes later. A call to the Children's hospital was made when her sugar level went as low as 40 at which time the doctor increased the meds which again helped for a little while. Again the babies sugar level began to decrease to low numbers and fluctuate as before with another call made and again meds were increased. The sugar level is again now decreasing with fluctuations. What to do next. I am so worried for my granddaughter as well as my daughter who is constantly watching over the baby. What might be the cause of this issue making it a long term problem for my granddaughter?
doctor
Answered by Dr. Dr. Pradeep Kumar Jain (1 hour later)
Brief Answer:
Frequent feeds with glucose supplement will help

Detailed Answer:
Hello

Thanks for the query

There can be various causes of hypoglycemia in new born right with varying severity right from decreased oral acceptance or infant of diabetic mother to excessive insulin production(insulinoma).The final management depends on the underlying disorder.Medications like diazoxide,glucagon helps in increasing the glucose level.A battery of test like urine test,serum insulin,tendem mass spectroscopy and cortisol level is needed to find out the underlying cause.
The transient improvement in blood sugar level can be done with supplementation of feeds with glucose.
I would like to know the birth weight(term/preterm) of the baby and also the current medication and diagnosis so that I better able to help you out.Meantime monitor blood sugar regularly and give feed supplemented with glucose to control sugar level.
I shall be glad to answer if you have any more query.
Regards


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Pradeep Kumar Jain (1 hour later)
Thank you for the answer. The baby weighed 7lbs 9 oz at birth and is currently taking Diazoxide. As far as a diagnosis goes, all that the doctor has shared at this point is that her Pancreas may be producing to much Insulin.
doctor
Answered by Dr. Dr. Pradeep Kumar Jain (8 hours later)
Brief Answer:
Dose of diazoxide may need to be increased to maximum

Detailed Answer:
Thanks for the follow up

As your doctors have said that the hypoglycemia is due to increased insulin production I assume that she has undergone all the investigations(it is important to know the underlying cause of increased insulin production as management would be based on that only) and are normal.
In this condition where all the tests are normal the dose of Diazoxide needs to be increased to combat this transient hyperinsulinemia.
Even after this if blood sugar is fluctuating I would like to get her admitted in hospital and to start some other medication like somatostatin or octreotide for maintaining the blood sugar as repeated hypoglycemia has its own detrimental effects.
Regards
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Pradeep Kumar Jain

Pediatrician, Cardiology

Practicing since :2006

Answered : 2073 Questions

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What Causes Hypoglycemia In New Born?

Brief Answer: Frequent feeds with glucose supplement will help Detailed Answer: Hello Thanks for the query There can be various causes of hypoglycemia in new born right with varying severity right from decreased oral acceptance or infant of diabetic mother to excessive insulin production(insulinoma).The final management depends on the underlying disorder.Medications like diazoxide,glucagon helps in increasing the glucose level.A battery of test like urine test,serum insulin,tendem mass spectroscopy and cortisol level is needed to find out the underlying cause. The transient improvement in blood sugar level can be done with supplementation of feeds with glucose. I would like to know the birth weight(term/preterm) of the baby and also the current medication and diagnosis so that I better able to help you out.Meantime monitor blood sugar regularly and give feed supplemented with glucose to control sugar level. I shall be glad to answer if you have any more query. Regards