The Journal of Pediatrics
Volume 155, Issue 5 , Pages 612-617, November 2009

Knowledge Gaps and Research Needs for Understanding and Treating Neonatal Hypoglycemia: Workshop Report from Eunice Kennedy Shriver National Institute of Child Health and Human Development

  • William W. Hay Jr., MD

      Affiliations

    • Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
    • ,
  • Tonse NK. Raju, MD, DCH

      Affiliations

    • Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
    • Corresponding Author InformationReprint requests: Tonse N. K. Raju, MD, DCH, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd, Room 4B03, Bethesda, MD, 20892.
    • ,
  • Rosemary D. Higgins, MD

      Affiliations

    • Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
    • ,
  • Satish C. Kalhan, MBBS, FRCP

      Affiliations

    • Department of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
    • ,
  • Sherin U. Devaskar, MD

      Affiliations

    • Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles & Mattel Children's Hospital UCLA, Los Angeles, CA

Received 23 March 2009; received in revised form 1 June 2009; accepted 22 June 2009.

Maintenance of glucose homeostasis via initiation of glucose production is one of the critical physiological events that results in a smooth transition and adaptation to extrauterine life. A number of neonates have difficulty during transition to the extrauterine environment that result in altered glucose homeostasis and low plasma glucose concentrations. Although much progress has been made over the years in understanding the causes and mechanisms of altered neonatal glucose metabolism, the long-term consequences and the threshold values that may cause injury remain unknown. In 2000, Cornblath et al summarized the contemporary state of knowledge related to neonatal hypoglycemia by noting the following:

Unfortunately, untoward long-term outcomes in infants with one or two low blood glucose levels have become the grounds for litigation and for alleged malpractice, even though the causative relationship between the two is tenuous at best…The definition of clinically significant hypoglycemia remains one of the most confused and contentious issues in contemporary neonatology.1

GLUT, Glucose transporter, MCT, Monocarboxylate transporter, MRI, Magnetic resonance imaging, SGA, Small for gestational age

 

 Editor's Note: The National Institutes of Health organizes focused workshops on topics that are in need of new clinical approaches or research. This article summarizes a workshop on neonatal hypoglycemia.

 —Alan H. Jobe, MD, PhD

 Funded by NICHD and NIH Office of Rare Diseases. Additional funding was received by The March of Dimes Foundation to the general NICHD gift fund. The American Academy of Pediatrics sponsored the travels of six speakers (none is the author) to this meeting. The study sponsors and co-funders were not involved on the conference agenda, discussions of materials, and interpretation of the presentations, the writing of the report, and the decision to submit the report for publications. The opinions expressed in this article are those of the author alone. They are not necessarily those of the US Department of Health and Human Services or of the National Institutes of Health, or of the co-sponsors. The authors declare no potential conflicts.

PII: S0022-3476(09)00613-1

doi:10.1016/j.jpeds.2009.06.044

The Journal of Pediatrics
Volume 155, Issue 5 , Pages 612-617, November 2009

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