• Medicine · Sep 2024

    Review

    Hypoglycemia and hyperglycemia in neonatal encephalopathy: A narrative review.

    • Sughra Asif, Maryam Shaukat, Kashaf Khalil, Hadiya Javed, Muhammad Safwan, Khadija Alam, Sabahat Fatima, Prishotam Chohan, Huraim Muhammad Hanif, Mohammed Mahmmoud Fadelallah Eljack, Muhammad Daim Bin Zafar, and Muhammad Hasanain.
    • Saidu Medical College, Swat, Pakistan.
    • Medicine (Baltimore). 2024 Sep 6; 103 (36): e39488e39488.

    AbstractNeonatal encephalopathy (NE) is a serious condition with various neurological dysfunctions in newborns. Disruptions in glucose metabolism, including both hypoglycemia and hyperglycemia, are common in NE and can significantly impact outcomes. Hypoglycemia, defined as blood glucose below 45 mg/dL, is associated with increased mortality, neurodevelopmental disabilities, and brain lesions on MRI. Conversely, hyperglycemia, above 120 to 150 mg/dL, has also been linked to heightened mortality, hearing impairment, and multiorgan dysfunction. Both aberrant glucose states appear to worsen prognosis compared to normoglycemic infants. Therapeutic hypothermia is the standard of care for NE that provides neuroprotection by reducing metabolic demands and inflammation. Adjunct therapies like glucagon and continuous glucose monitoring show promise in managing dysglycemia and improving outcomes. Glucagon can enhance cerebral blood flow and glucose supply, while continuous glucose monitoring enables real-time monitoring and personalized interventions. Maintaining balanced blood sugar levels is critical in managing NE. Early detection and intervention of dysglycemia are crucial to improve outcomes in neonates with encephalopathy. Further research is needed to optimize glycemic management strategies and explore the potential benefits of interventions like glucagon therapy.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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