Turkish Archives of Pediatrics
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Neonatal Hyperglycemia, which threshold value, diagnostic approach and treatment?: Turkish Neonatal and Pediatric Endocrinology and Diabetes Societies consensus report

1.

Division of Pediatric Endocrinology, Department of Pediatrics, Ege University, Faculty of Medicine, İzmir, Turkey

2.

Division of Neonatology, Department of Pediatrics, Başkent University, Faculty of Medicine, Ankara, Turkey

3.

Division of Pediatric Endocrinology, Department of Pediatrics, Erciyes University, Faculty of Medicine, Kayseri, Turkey

4.

Division of Neonatology, Department of Pediatrics, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey

5.

Division of Neonatology, Department of Pediatrics, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey

6.

Division of Pediatric Endocrinology, Department of Pediatrics, İstanbul Üniversitesi, İstanbul Faculty of Medicine, İstanbul, Turkey

7.

Division Pediatric Endocrinology, Department of Pediatrics, Koç University, Faculty of Medicine, İstanbul, Turkey

8.

Division Pediatric Endocrinology, Department of Pediatrics, Gazi University, Faculty of Medicine, Ankara, Turkey

9.

Division of Neonatology, Department of Pediatrics, Marmara University, Faculty of Medicine, İstanbul, Turkey

Turk Arch Pediatr 2018; 53: Supplement S234-S238
DOI: 10.5152/TurkPediatriArs.2018.01821
Read: 319 Downloads: 213 Published: 29 November 2020

Hyperglycemia has become an important risk factor for mortality and morbidity in the neonatal period, especially with increased survival rates of very low birth weight babies. Hyperglycemia in the neonatal period develops as a result of various mechanisms including iatrogenic causes, inability to supress hepatic glucose production, insulin resistance or glucose intolerance, specifically in preterm babies. Initiation of parenteral or enteral feeding in the early period in preterm babies increases insulin production and sensitivity. The plasma glucose is targeted to be kept between 70 and 150 mg/dL in the newborn baby. While a blood glucose value above 150 mg/dL is defined as hyperglycemia, blood glucose values measured with an interval of 4 hours of >180-200 mg/dL and +2 glucosuria require treatment. Although glucose infusion rate is reduced in treatment, use of insulin is recommended, if two blood glucose values measured with an interval of 4 hours are >250 mg/dL and glucosuria is present in two separate urine samples.


Yenidoğan hiperglisemisi, hangi eşik değer, tanısal yaklaşım ve tedavi?: Türk Neonatoloji ve Çocuk Endokrinoloji ve Diyabet Dernekleri uzlaşı raporu

Yenidoğan döneminde özellikle çok düşük doğum ağırlıklı bebeklerin yaşamda kalmaya başlamaları ile birlikte, hiperglisemi morbidite ve mortalite için önemli bir risk etmeni olmuştur. Yenidoğan döneminde özellikle preterm bebeklerde hiperglisemi, iyatrojenik nedenler, karaciğerde glukoz üretiminin baskılanamaması, insülin direnci ya da glukoz intoleransı gibi mekanizmalar sonucu gelişmektedir. Preterm bebeklerin erken dönemde parenteral ya da enteral beslenmeye başlanması; insülin yapımını ve duyarlılığını arttırır. Yenidoğan bebekte kan şekerinin 70-150 mg/dL arasında olması hedeflenmektedir. Kan şeker düzeyi >150 mg/dL olması hiperglisemi olarak tanımlanırken; 4 saat ara ile bakılan kan şekerinin >180-200 mg/dL olması ve +2 glukozüri olması tedaviyi gerektirmektedir. Tedavide glukoz infüzyon hızı azaltılmasına rağmen; 4 saat ara ile bakılan 2 kan şekeri değeri >250 mg/dL ve alınan iki ayrı idrar örneğinde glukozüri varsa insülin kullanılması önerilmektedir.

Cite this article as: Gökşen Şimşek D, Ecevit A, Hatipoğlu N, et al. Neonatal Hyperglycemia, which threshold value, diagnostic approach and treatment?: Turkish Neonatal and Pediatric Endocrinology and Diabetes Societies consensus report. Turk Pediatri Ars 2018; 53(Suppl 1): S234-S238.

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