Hypoglycemia screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]


Screening of hypoglycemia should be obtained in infants who are at risk for hypoglycemia. Surveillance should be continued every three to six hours for the first 48 hours of life. Treatment should be started immediately after a primary blood test.


Screening of hypoglycemia should be obtained in infants who are at risk for hypoglycemia:

  • First feed should occur within one hour after birth even before the screening.
  • Surveillance should be continued every three to six hours for the first 24 to 48 hours of life.[1]
  • Neonates with low blood glucose concentrations should be continually monitored until concentrations can be maintained with regular feedings in a normal range of >50 mg/dL.
  • Hypoglycemia disorder should be considered if an infant is unable to maintain glucose concentrations >60 mg/dL after 48 hours of age.
  • Plasma glucose concentration in an infant with a low glucose value determined by a finger stick glucose measure should be confirmed by laboratory measurement. Glucose concentration measured in whole blood is 15% lower than that in plasma.[2][3]
  • Treatment should be started immediately after primary blood test and we should not wait for the confirmatory laboratory results due to high risk of the neurological outcome.
  • Continuous glucose monitoring using a sensor that measures interstitial glucose concentration was reported to be reliable.[4]


  1. Harris DL, Weston PJ, Harding JE (2012). "Incidence of neonatal hypoglycemia in babies identified as at risk". J Pediatr. 161 (5): 787–91. doi:10.1016/j.jpeds.2012.05.022. PMID 22727868.
  2. Stanley CA, Rozance PJ, Thornton PS, De Leon DD, Harris D, Haymond MW; et al. (2015). "Re-evaluating "transitional neonatal hypoglycemia": mechanism and implications for management". J Pediatr. 166 (6): 1520–5.e1. doi:10.1016/j.jpeds.2015.02.045. PMC 4659381. PMID 25819173.
  3. Committee on Fetus and Newborn. Adamkin DH (2011). "Postnatal glucose homeostasis in late-preterm and term infants". Pediatrics. 127 (3): 575–9. doi:10.1542/peds.2010-3851. PMID 21357346.
  4. Wackernagel D, Dube M, Blennow M, Tindberg Y (2016). "Continuous subcutaneous glucose monitoring is accurate in term and near-term infants at risk of hypoglycaemia". Acta Paediatr. 105 (8): 917–23. doi:10.1111/apa.13479. PMID 27203555.