Monitoring for neonatal hypoglycaemia

Exposure to high blood glucose concentrations in utero can lead to neonatal hyperinsulinaemia and neonatal hypoglycaemia, defined as a blood glucose concentration less than 2.6 mmol/L. The neonate should be monitored for hypoglycaemia for at least 24 hours. Monitoring is usually by heel prick every 3 to 4 hours before or after feeds, according to local protocols.

Most neonates born to mothers with pre-existing diabetes will require admission to a neonatal intensive care unit or special care nursery. They need specialist assessment and monitoring for respiratory distress, hyperbilirubinaemia, hypocalcaemia, polycythaemia, cardiomyopathy and sepsis, especially if they become unwell.