Pathogenetic aspects, diagnosis and principles of treatment of newborn hypoglycaemia

Abstract

Introductions. Glucose is one of the components of the internal environment of the body, the concentration of which in the blood is maintained at a relatively constant level. Conditions associated with an increase or decrease in blood glucose are dangerous to the body. In clinical medicine, very much attention is paid to hyperglycemia, but hypoglycemia is quite common, especially in infants in the neonatal period. Hypoglycemia in infants occurs with a frequency of 1-3 cases per 1000 live births, and in infants with low birth weight it is observed in 14.7%. Decreased blood sugar in a child can be a symptom of severe hereditary metabolic disorders. It is known that the frequency of hereditary diseases with hypoglycemia is 1: 50,000 live births, of which the deficiency of acyl-CoA dehydrogenase with a medium chain (MCAD) – 1: 4900-1: 17000; incidence of hyperinsulinism – 1: 2500. The most common causes of persistent hypoglycemia in newborns are low gluconeogenesis due to congenital enzyme defects and disorders of hormonal regulation. Congenital metabolic disorders can be manifested by episodes of hypoglycemia during metabolic crises, which can be life-threatening if not diagnosed and treated in time. The first manifestation of a congenital metabolic error can be at any age, and most cases occur during metabolic stress or transition, with various diseases or changes in diet. Therefore, a preliminary diagnosis should be made as soon as possible and treatment of the sick newborn should be started.