Neonatal hypoglycemia (Draft of clinical guidelines)

Neonatal hypoglycemia is one of the most common metabolic disorders in newborns, characterized by a high risk of developing neurological complications, including long-term ones, and, as a consequence, leading to a decrease in the quality of life of patients. As a rule, neonatal hypoglycemia is transient and is caused by the physiological characteristics of the infant’s body. The mechanism of development of transient neonatal hypoglycemia is based on transient hyperinsulinism and deficiency of alternative glucose sources in the neonatal period. In some cases, hypoglycemia can be caused by congenital metabolic disorders, enzymopathies and endocrine diseases. The frequency of neonatal hypoglycemia varies depending on the diagnostic threshold, the screening protocol used, the method of measuring blood glucose levels, and the population studied. According to the latest meta-analyses and systematic reviews, neonatal hypoglycemia is observed in 5–15% of healthy newborns and in 50% of children from the risk group. Despite the large number of clinical protocols for the management of patients with neonatal hypoglycemia, there is no single algorithm. This draft clinical guidelines for the diagnosis and treatment of neonatal hypoglycemia in children were prepared by a group of authors, leading domestic specialists in the field of neonatology, pediatrics and pediatric endocrinology. The information on the epidemiology, modern classification of neonatal hypoglycemia, methods of their diagnosis, screening and treatment, based on the principles of evidence-based medicine, is presented.