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Thresholds for intervention and targets for treatment in term and late preterm newborns with hypoglycemia

Thresholds for intervention and targets for treatment in term and late preterm newborns with hypoglycemia
Thresholds for intervention
Patient category Age Serum glucose level
Symptomatic patients <48 hours <50 mg/dL (2.8 mmol/L)
≥48 hours <60 mg/dL (3.3 mmol/L)
Asymptomatic patients <4 hours <25 mg/dL (1.4 mmol/L)
4 to <24 hours <35 mg/dL (1.9 mmol/L)
24 to <48 hours <50 mg/dL (2.8 mmol/L)
≥48 hours <60 mg/dL (3.3 mmol/L)
Suspected primary hypoglycemia disorder Any <70 mg/dL (3.9 mmol/L)
Target range during treatment (applies to all categories above)
Lower limit Upper limit
Same as thresholds above 90 to 100 mg/dL (5 to 5.5 mmol/L)
This table summarizes threshold and target blood glucose levels used for management of neonatal hypoglycemia in term and late preterm infants born at ≥35 weeks gestation. Symptoms of hypoglycemia in newborns may include jitteriness/tremors, pathological hypotonia, changes in level of consciousness, apnea/bradycardia, cyanosis, tachypnea, pathological poor feeding, sustained hypothermia, and/or seizures. Infants with asymptomatic hypoglycemia are typically identified through glucose screening performed due to underlying risk factors (eg, maternal diabetes, large or small for gestational age, late preterm), or it may be identified as an incidental laboratory finding. For additional details, refer to UpToDate topics on neonatal hypoglycemia.
Graphic 138387 Version 2.0

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