Perinatal glucose homeostasis: the unique character of hyperglycemia and hypoglycemia in infants of very low birth weight.

Tiny babies have the potential problem of hypoglycemia due to diminished hepatic glycogen stores, which can be potentiated by conditions frequently present in this birth weight group: asphyxia, cold stress, hypoxia, polycythemia. Despite the early administration of fluid and feeding, tiny babies are still at risk for developing hypoglycemia. Their immaturity, expressed by their limited ability to tolerate parenteral glucose infusions, puts them at risk for becoming hyperglycemic as well. Hence careful glucose administration and frequent monitoring of blood glucose are essential during the first several days after birth, in anticipation of hypoglycemia as well as hyperglycemia.