The screening and management of newborns at risk for low blood glucose

Abstract Hypoglycemia in the first hours to days after birth remains one of the most common conditions facing practitioners across Canada who care for newborns. Many cases represent normal physiologic transition to extrauterine life, but another group experiences hypoglycemia of longer duration. This statement addresses key issues for providers of neonatal care, including the definition of hypoglycemia, risk factors, screening protocols, blood glucose levels requiring intervention, and managing care for this condition. Screening, monitoring, and intervention protocols have been revised to better identify, manage, and treat infants who are at risk for persistent, recurrent, or severe hypoglycemia. The role of dextrose gels in raising glucose levels or preventing more persistent hypoglycemia, and precautions to reduce risk for recurrence after leaving hospital, are also addressed. This statement differentiates between approaches to care for hypoglycemia during the ‘transitional’ phase—the first 72 hours post-birth—and persistent hypoglycemia, which occurs or presents for the first time past that point.

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The Role of Biomaterials in Insulin Delivery Systems

The International Journal of Artificial Organs ◽

10.1177/039139888000300513 ◽

1980 ◽

Vol 3 (5) ◽

pp. 299-304 ◽

Cited By ~ 1

Author(s):

S.D. Bruck

Keyword(s):

Blood Glucose ◽

Glucose Sensor ◽

Insulin Delivery ◽

The United States ◽

Delivery Systems ◽

Open Loop ◽

Health Concern ◽

Glucose Levels ◽

Blood Glucose Levels

The control of blood glucose levels in diabetes involving devices are critically reviewed, and the role of blood-contacting biomaterial components analyzed. These include mechanical insulin-delivery systems of the closed-loop type that require an electronic glucose sensor and feedback, and open-loop systems that deliver insulin without a sensor and feedback. Whole pancreatic and islet transplantations, islet encapsulation, and the potential role of polymeric sustained drug delivery systems are discussed. The medical and social impacts of diabetes mellitus are of prime public health concern and of even greater magnitude than those of heart disease in the United States. While future advances in device design, miniaturization, and biometrials technology will significantly add to the arsenal of therapeutic alternatives, devices capable of controlling blood glucose levels ought to be viewed as mere interim phases rather than as final goals of the problem.

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Liver glycogen content decreases during meals in rats

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.1982.243.3.r450 ◽

1982 ◽

Vol 243 (3) ◽

pp. R450-R453

Author(s):

W. Langhans ◽

N. Geary ◽

E. Scharrer

Keyword(s):

Blood Glucose ◽

Glycogen Content ◽

Liver Glycogen ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Liver Glycogen Content ◽

Ad Libitum ◽

Portal Veins ◽

Hepatic Portal

The effects of feeding on liver glycogen content and blood glucose in the hepatic and hepatic portal veins were investigated in rats. Liver glycogen content decreased about 25% during meals both in rats refed after 12 h food deprivation (23 +/- 1 to 17 +/- 1 mg glycogen/g liver) and in ad libitum-fed rats taking fully spontaneous meals (44 +/- 2 to 32 +/- 2 mg/g). Liver glycogen began to increase within 30 min after meals in ad libitum-fed rats. Hepatic vein blood glucose levels at meal onset (118 +/- 4 mg/dl in the food-deprived rats, 127 +/- 4 in ad libitum-fed rats) and at meal end (155 +/- 3 and 166 +/- 5 mg/dl, respectively) were similar in the two groups. Portal vein blood glucose increased during meals in the previously food-deprived rats (83 +/- 4 to 116 +/- 6 mg/dl) but not in the ad libitum-fed rats (127 +/- 5 to 132 +/- 3 mg/dl). Mechanisms that may elicit prandial glycogenolysis and the possible role of this effect in the production of meal ending satiety are discussed.

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Two hour blood glucose levels in at-risk babies: An audit of Canadian guidelines

Paediatrics & Child Health ◽

10.1093/pch/14.4.238 ◽

2009 ◽

Vol 14 (4) ◽

pp. 238-244 ◽

Cited By ~ 6

Author(s):

Jennifer Croke ◽

Meagan Sullivan ◽

Anne Ryan-Drover ◽

Ed Randell ◽

Wayne Andrews ◽

...

Keyword(s):

At Risk ◽

Blood Glucose ◽

Glucose Levels ◽

Blood Glucose Levels

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Role of adrenoceptors in vitro and in vivo in the effects of lithium on blood glucose levels and insulin secretion in the rat

British Journal of Pharmacology ◽

10.1111/j.1476-5381.1990.tb15796.x ◽

1990 ◽

Vol 100 (2) ◽

pp. 283-288 ◽

Cited By ~ 7

Author(s):

T. Fontela ◽

O. García Hermida ◽

J. Gómez-Acebo

Keyword(s):

Insulin Secretion ◽

Blood Glucose ◽

Glucose Levels ◽

Blood Glucose Levels

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Capsaicin-sensitive nerves are required for glucostasis but not for catecholamine output during hypoglycemia in rats

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1990.258.1.e212 ◽

1990 ◽

Vol 258 (1) ◽

pp. E212-E219 ◽

Cited By ~ 5

Author(s):

X. F. Zhou ◽

K. H. Jhamandas ◽

B. G. Livett

Keyword(s):

Blood Glucose ◽

Somatostatin Analogue ◽

Plasma Epinephrine ◽

Conscious Rat ◽

Glucose Response ◽

Conscious Rats ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Sensory Fibers

We have studied the glucose response and catecholamine (CA) response to insulin in the conscious rat to evaluate the role of sensory fibers in these responses in animals pretreated with capsaicin as neonates. In contrast to previous results obtained in anesthetized rats (Z. Khalil, B.G. Livett, and P.D. Marley. J. Physiol. Lond. 370: 201-215, 1986; Z. Khalil, B.G. Livett, and P.D. Marley. J. Physiol. Lond. 391: 511-526, 1987.), in conscious rats, insulin (1 IU/kg iv) produced only a mild hypoglycemia, which quickly returned to resting levels and caused no significant changes in plasma epinephrine levels. Somatostatin and SMS-(201-995), a somatostatin analogue, both potentiated and prolonged the insulin-induced hypoglycemia, resulting in an increase in circulating CA levels that was suppressed by hexamethonium and atropine. In capsaicin-pretreated rats the blood glucose levels at 90 min after insulin were significantly lower than those in vehicle-pretreated rats both in the presence (1 IU/kg insulin, 48 +/- 6 vs. 92 +/- 6 mg/100 ml, P less than 0.01) and absence (10 IU/kg insulin, 38 +/- 4 vs. 51 +/- 2 mg/100 ml, P less than 0.01) of SMS-(201-995). The CA levels in capsaicin-pretreated rats at 90 min after insulin were higher than in vehicle-pretreated rats (epinephrine levels: 27 +/- 4 vs. 10 +/- 1 pmol/ml in 1 IU/kg insulin, P less than 0.01; 64 +/- 14 vs. 25 +/- 5 pmol/ml in 10 IU/kg insulin, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

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Role of PPAR in Hepatic Carbohydrate Metabolism

PPAR Research ◽

10.1155/2010/572405 ◽

2010 ◽

Vol 2010 ◽

pp. 1-12 ◽

Cited By ~ 36

Author(s):

Annelies Peeters ◽

Myriam Baes

Keyword(s):

Lipid Metabolism ◽

Blood Glucose ◽

Carbohydrate Metabolism ◽

Glucose Homeostasis ◽

Tight Control ◽

Master Regulator ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Ppar Ligands

Tight control of storage and synthesis of glucose during nutritional transitions is essential to maintain blood glucose levels, a process in which the liver has a central role. PPAR is the master regulator of lipid metabolism during fasting, but evidence is emerging for a role of PPAR in balancing glucose homeostasis as well. By using PPAR ligands and PPAR mice, several crucial genes were shown to be regulated by PPAR in a direct or indirect way. We here review recent evidence that PPAR contributes to the adaptation of hepatic carbohydrate metabolism during the fed-to-fasted or fasted-to-fed transition in rodents.

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Oreocnide integrifoliaFlavonoids Augment Reprogramming for Islet Neogenesis andβ-Cell Regeneration in Pancreatectomized BALB/c Mice

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/260467 ◽

2012 ◽

Vol 2012 ◽

pp. 1-13 ◽

Cited By ~ 3

Author(s):

Ansarullah ◽

Bhavna Bharucha ◽

Malati Umarani ◽

Mitesh Dwivedi ◽

Naresh C. Laddha ◽

...

Keyword(s):

Clinical Trials ◽

Blood Glucose ◽

Brdu Incorporation ◽

Cell Regeneration ◽

Mice Model ◽

Islet Neogenesis ◽

Glucose Levels ◽

Ductal Cells ◽

Blood Glucose Levels

Agents which can either trigger proliferation ofβ-cells or induce neogenesis ofβ-cells from precursors would be of pivotal role in reversing diabetic manifestations. We examined the role of flavonoid rich fraction (FRF) ofOreocnide integrifolialeaves using a mice model of experimental regeneration. BALB/c mice were subjected to ~70% pancreatectomy (Px) and supplemented with FRF for 7, 14, and 21 days after pancreatectomy. Px animals displayed increased blood glucose levels and decreased insulin titres which were ameliorated by FRF supplementation. FRF-treated mice demonstrated prominent newly formed islets budding off from ducts and depicting increased BrdU incorporation. Additionally, transcripts levels of Ins1/2, Reg-3α/γ, Ngn-3, and Pdx-1 were upregulated during the initial 1 week. The present study provides evidence of a nutraceutical contributing to islet neogenesis from ductal cells as the mode ofβ-cell regeneration and a potential therapeutic for clinical trials in management of diabetic manifestations.

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Partial protection against streptozotocin-induced hyperglycaemia by superoxide dismutase linked to polyethylene glycol

Acta Endocrinologica ◽

10.1530/acta.0.1070390 ◽

1984 ◽

Vol 107 (3) ◽

pp. 390-394 ◽

Cited By ~ 21

Author(s):

kjell Asplund ◽

Kjell Grankvist ◽

Stefan Marklund ◽

Inge-Bert Täljedal

Keyword(s):

Superoxide Dismutase ◽

Polyethylene Glycol ◽

Blood Glucose ◽

Superoxide Radicals ◽

High Dose ◽

Partial Protection ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Pre Treatment

Abstract. To test the possible role of superoxide radicals in the diabetogenic action of streptozotocin, blood glucose levels were measured in mice after a single high-dose (150 mg/kg body weight) or multiple low-dose (40 mg/kg for 5 days) injections of streptozotocin. Pre-treatment 6 h before streptozotocin with 250–300 mg/kg superoxide dismutase coupled to polyethylene glycol reduced the hyperglycaemic response in mice injected with a single dose of streptozotocin. The blood glucose levels after multiple low doses of streptozotocin were not affected by superoxide dismutase-polvethvlene glycol. Enzymatically inactive superoxide dismutase did not affect the development of hyperglycaemia. The results suggest that superoxide radicals may play a role in the diabetogenic action of streptozotocin injected as a high-dose single bolus.

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