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Diagnostic testing for persistent neonatal hypoglycemia

Diagnostic testing for persistent neonatal hypoglycemia
Initial diagnostic testing for persistent neonatal hypoglycemia (low glucose concentrations that persist beyond 48 hours of life) differentiates major etiologic categories of hypoglycemia based on laboratory testing (bicarbonate, beta-hydroxybutyrate, and free fatty acid) from a critical sample (obtained when the plasma glucose level is <50 mg/dL [2.8 mmol/L]). Additional specific testing (eg, plasma insulin, C-peptide, and carnitine and acyl-carnitine levels) using a critical sample is used to confirm the diagnosis of the underlying cause of hypoglycemia.
HCO3: bicarbonate; BOHB: beta-hydroxybutyrate; FFA: free fatty acid; GH: growth hormone.
Original figure modified for this publication. Thornton PS, Stanley CA, De Leon DD, et al. Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children. J Pediatr 2015. Illustration used with the permission of Elsevier Inc. All rights reserved.
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