Assess the risk factors of developing hypoglycemia among term infants born to diabetic mothers

Objective: to assess the risk factors of developing hypoglycemia among term infants born to diabetic mothers and to characterize rates of glucose concentrations in the first 2 days of life. Methods: A prospective study included all IDMs who were born at EL Kasr EL-Aini Hospital with exclusion of major congenital anomalies, polycythemia, respiratory distress, sepsis, asphyxia or other clinical manifestations not clearly attributed to hypoglycemia. Blood glucose level was measured immediately after delivery and over 48 hours, taking into consideration maternal data before and during pregnancy and neonatal data including gestational age, sex, body weight, apgar score, clinical manifestations of hypoglycemia and nutrition of the newborn. Results: Hypoglycemia at 0 hour was more among those born to uncontrolled diabetic mothers, mothers who were on insulin therapy (either GDM-A2 or IDDM) , severe hypoglycemia after birth and on the 1st day of life was more common in neonates that were born to hypertensive, uncontrolled diabetic mothers as well as to mothers on insulin therapy. The mean of glucose values on the 2nd day of life showed improvement for the majority of the neonates. Conclusions: It seems that infants born to diabetic mothers tend to have very high rates of hypoglycemia on the first day of life when a higher cut-off point is used. When considering glucose values in newborn infants, it is necessary to distinguish between ‘common’ glucose values that can be low not only among high-risk infants and values of infants born to diabetic mothers. Then it must be decided whether these values should be accepted as ‘normal’ or, as suggested in a number of recent studies. Whether they indicate a correlation between hypoglycemia (even moderate and asymptomatic) and unfavorable outcome, leading to a recommendation to maintain higher glucose levels.