Division of Endocrinology and Diabetes, Department of Pediatrics, Arkansas Children's Hospital, Little Rock, AR.
Division of Endocrinology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA.
Neoreviews. 2020 Jan;21(1):e14-e29. doi: 10.1542/neo.21-1-e14.
Physiologic adaptations in the postnatal period, along with gradual establishment of enteral feeding, help maintain plasma glucose concentrations in the neonatal period. The definition of normal plasma glucose in the neonatal period has been a subject of debate because of a lack of evidence linking a set plasma or blood glucose concentration to clinical symptoms or predictors of short- and long-term outcomes. However, there is consensus that maintaining plasma glucose in the normal range for age is important to prevent immediate and long-term neurodevelopmental consequences of hypoglycemia or hyperglycemia. The specific management strategy for abnormal glucose levels in neonates depends on the underlying etiology, and interventions could include nutritional changes, medications, hormone therapy, or even surgery. Here, we will review the physiological processes that help maintain plasma glucose in newborns and discuss the approach to a newborn with disordered glucose homeostasis, with an emphasis on the endocrine basis of abnormal glucose homeostasis.
新生儿期的生理适应以及逐渐建立的肠内喂养有助于维持血糖浓度。由于缺乏将特定血浆或血糖浓度与临床症状或短期和长期结局的预测因素联系起来的证据，新生儿期正常血糖的定义一直存在争议。然而，人们普遍认为，将血糖维持在与年龄相适应的正常范围内对于预防低血糖或高血糖的即刻和长期神经发育后果非常重要。新生儿血糖异常的具体管理策略取决于潜在病因，干预措施可能包括营养改变、药物治疗、激素治疗甚至手术。在这里，我们将回顾帮助维持新生儿血糖的生理过程，并讨论血糖稳态紊乱新生儿的处理方法，重点介绍异常血糖稳态的内分泌基础。
