Neonatal hyperglycemia

[Britney]

Hyperglycemia is a serum glucose concentration gt; 150 mg/dL (gt; 8.3 mmol/L). Diagnosis is with serum glucose testing. Treatment is reduction of the IV dextrose concentration or of the infusion rate, or IV insulin.
The most common cause of neonatal hyperglycemia is

Iatrogenic

Iatrogenic causes usually involve too-rapid IV infusions of dextrose during the first few days of life in very low-birth-weight infants (lt; 1.5 kg).
The other important cause is physiologic stress caused by surgery, hypoxia, respiratory distress syndrome, or sepsis; fungal sepsis poses a special risk. In premature infants, partially defective processing of proinsulin to insulin and relative insulin resistance may cause hyperglycemia. In addition, transient neonatal diabetes mellitus is a rare self-limited cause that usually occurs in small-for-gestational-age infants; corticosteroid therapy may also result in transient hyperglycemia. Hyperglycemia is less common than hypoglycemia, but it is important because it increases morbidity and mortality of the underlying causes.